側頭骨に発生した軟骨芽細胞腫の2例  [in Japanese] Two cases of chondroblastoma of the temporal bone  [in Japanese]

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Abstract

<b>背景</b> : 軟骨芽細胞腫は若年者の長管骨骨端部に好発する良性骨腫瘍である. 側頭骨発生の軟骨芽細胞腫はまれで, 細胞像の報告例は限られている.<br><b>症例</b> : 症例 1 は 50 歳男性. 1.5 cm 大の左側頭骨腫瘤に対して穿刺吸引細胞診および生検術が行われるも診断にいたらなかった. 部分切除術が行われ病理学的に軟骨芽細胞腫と診断された. 残存腫瘍の増大に対し再摘出術が行われ捺印細胞診を施行した. 穿刺吸引細胞診と捺印細胞診のいずれにも清明な背景に多数の類円形単核細胞と破骨細胞型多核巨細胞が出現していた. 単核細胞の核は類円形または楕円形で, 括れや核溝を有する核も認められた. 細胞質はライトグリーン好性で境界明瞭だった. 症例 2 は 58 歳男性. 2 cm 大の右側頭骨腫瘤の摘出術の際に捺印細胞診を行った. 症例 1 と同様の単核細胞と破骨細胞型多核巨細胞の出現のほかに, Giemsa 染色でメタクロマジーを示す細胞外基質も認められた.<br><b>結論</b> : 単核細胞と破骨細胞型多核巨細胞からなる側頭骨病変には軟骨芽細胞腫を含め多くの鑑別疾患があがる. 臨床所見や画像検査に加え, 特徴的な軟骨芽細胞やメタクロマジーを示す細胞外基質などの細胞診所見が鑑別に有用である.

<b><i>Background</i></b> : Chondroblastoma is a benign bone tumor which usually occurs in the epiphysis of long bones in young persons. Chondroblastoma involving the temporal bone is rare. Few case reports on its cytological findings have been published.<br><b><i>Case 1</i></b> : A 50-year-old man presented with a 1.5 cm mass in the left temporal bone. Pre-operative fine needle aspiration cytology made no definite diagnosis. The lesion was partially removed, and histologically diagnosed as a chondroblastoma. Stamp preparation was obtained at additional excision of the remaining tumor. Both aspiration and touch smear cytology showed a mixture of mononuclear round tumor cells and osteoclast-type giant cells (OCGCs) within a clear background. Mononuclear cells had round to oval nuclei with grooved or constricted nuclear membrane. Their cytoplasm was well circumscribed and stained light green.<br><b><i>Case 2</i></b> : A 58-year-old man presented with a 2 cm mass in the right temporal bone. The touch smear preparation which was obtained at tumorectomy contained the same mononuclear cells and OCGCs as case 1. Additionally, extracellular matrix with metachromasia was observed.<br><b><i>Conclusion</i></b> : Chondroblastoma of the temporal bone should be distinguished from other diseases that are composed of mononuclear cells and OCGCs. Along with clinical and radiological findings, cytological features such as characteristic chondroblasts and extracellular matrix with metachromasia are helpful for differential diagnosis.

Journal

  • The Journal of the Japanese Society of Clinical Cytology

    The Journal of the Japanese Society of Clinical Cytology 52(3), 259-264, 2013-05-22

    The Japanese Society of Clinical Cytology

References:  15

Codes

  • NII Article ID (NAID)
    10031158825
  • NII NACSIS-CAT ID (NCID)
    AN00198721
  • Text Lang
    JPN
  • Article Type
    NOT
  • ISSN
    03871193
  • Data Source
    CJP  J-STAGE 
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