Chordoma

Squash smear and fine needle aspiration features of conventional chordoma

“…Conventional chordoma, with its quite distinctive microscopic features, can be successfully diagnosed by cytological examination. [8][9][10][11][12] Cytologically, it can be examined as a squash smear specimen during neurosurgical intraoperative consultation or as a fine needle aspiration specimen. Obtained cytological material is usually easily smeared.…”

“…12,13 Usually, they are described as large polygonal or epithelioid cells with large cytoplasmic vacuoles, but some authors use more strict criteria and for diagnosis require a high nuclear/ cytoplasmic ratio or a "spider cell" appearance, where cytoplasmic strands surround vacuoles and nuclei. 8,14,15 If Romanowsky-type stains are used, physaliferous cells usually appear poorly stained (Figure 5). Lack of uniform definition leads to huge differences in the assessment of the amounts of these cells among authors because not all cells with "bubbly" cytoplasm are true physaliferous cells.…”

“…Lack of uniform definition leads to huge differences in the assessment of the amounts of these cells among authors because not all cells with "bubbly" cytoplasm are true physaliferous cells. 8,12 Besides physaliferous cells, there are other types of cells with cytoplasmic vacuoles, including signet-ring cells, and smaller cells with granular cytoplasm without cytoplasmic vacuoles. Similar to the stromal elements, cytoplasmic vacuoles are best appreciated in Romanowsky-type stains.…”

“…Cell borders are usually prominent in dispersed cells and can be absent within syncytial cell groups. 8,12,13 In less than half of the cases, intranuclear cytoplasmic pseudoinclusions can be observed (Figure 6). 8 In some cases atypical cytological features, like significant pleomorphism, hyperchromasia and mitotic activity, may be observed, but the significance of these findings is not yet well understood.…”

Management of Chordoma of the Sacrum and Mobile Spine

“…Chordomas share many characteristics with other vertebral tumors, such as chondrosarcomas and benign notochordal cell tumors (BNCTs), and a biopsy is a definitive study to differentiate these lesions. Chondrosarcomas are distinguished from chordomas by staining negative for brachyury, cytokeratin, and epithelial markers, whereas chordomas stain positive 2,6,51 . BNCTs contain the same physaliferous cells and occur in similar locations as chordomas 2 .…”