Squash Cytology of a Dural-Based High-Grade Chondrosarcoma May Mimic That of Glioblastoma in the Central Nervous System

Abstract

Background: Intracranial chondrosarcoma is rare, and most cases occur in the skull base. Intradural chondrosarcoma is even rarer. Case: Here, we describe a case of dural chondrosarcoma with a radiation history for nasopharyngeal carcinoma and a radical prostatectomy for prostatic cancer 15 and 8 years earlier, respectively. A 67-year-old man presented with a 3-week memory disturbance and dysarthria. Computed tomography and magnetic resonance images of the brain revealed a dural-based mass in the left temporal area. Under the impression of a glioblastoma, a resection and an intraoperative squash cytology were done. A necrotic dirty background as well as bluish-to-pinkish myxoid stroma were characteristic; the nuclei of highly pleomorphic tumor cells were hyperchromatic to vesicular with an occasional ground-glass appearance. The cytoplasm was of an eosinophilic hyalinized condensed morphology with an occasional granular appearance. Histologically, the lobulated mass was composed of hypercellular lobules of well-differentiated chondrocytes intermixed with anaplastic pleomorphic cells and diagnosed as a conventional grade III chondrosarcoma. These cells were immunoreactive for D2-40, S-100 protein and vimentin. Brain invasion was also found. Conclusion: Albeit rare, dural-based chondrosarcomas should be considered in the differential diagnosis for meningeal tumors, especially in the case of previous radiation therapy.

Intraoperative Frozen Cytology of Central Nervous System Neoplasms: An Ancillary Tool for Frozen Diagnosis

“…Radiation injury may mimic glioblastoma by cytological findings such as bizarre nuclear features [12]. Necrosis and vascular endothelial proliferation are reliable cytologic findings of high-grade glioma [10,13,14]. Because they share clinicoradiologic findings, glioblastoma should be distinguished from metastasis and lymphoma.…”

Intraoperative frozen cytology of intraosseous cystic meningioma in the sphenoid bone

“…Scattered stellate, vacuolated cells, and foam cells may be found in regions of microcystic meningiomas [13]. Singly-scattered tumor cells with intracytoplasmic vacuoles in foci of microcystic meningioma resembling atypical chondrocytes of chondrosarcoma and lipoblasts of liposarcoma were occasionally found [15]. Cytologic findings of chondrosarcoma are moderately cellular with clusters of polygonal cells showing occasional binucleation and well-defined cytoplasm with rounded nuclei showing moderate nuclear pleomorphism embedded in a chondromyxoid background, suggestive of chondrosarcoma [15].…”

“…Singly-scattered tumor cells with intracytoplasmic vacuoles in foci of microcystic meningioma resembling atypical chondrocytes of chondrosarcoma and lipoblasts of liposarcoma were occasionally found [15]. Cytologic findings of chondrosarcoma are moderately cellular with clusters of polygonal cells showing occasional binucleation and well-defined cytoplasm with rounded nuclei showing moderate nuclear pleomorphism embedded in a chondromyxoid background, suggestive of chondrosarcoma [15]. Cytologic findings of chordoma are characterized by mucoid and gelatinous fibromyxoid cellular smears and cords or clusters of round epithelioid cells with small round nuclei and scant basophilic cytoplasm and occasional large physaliphorous cells with central small round nuclei and bubbly cytoplasm [16].…”

The Continuing Value of Ultrastructural Observation in Central Nervous System Neoplasms in Children

“…Excluding components of gliosarcoma, pediatric brain sarcomas are rare. However, various types of primary intracranial sarcomas can occur in the absence of radiation history [ 38 , 39 ]. Although rare cases of rhabdomyosarcoma or chondrosarcoma have also been described, most reported cases in children are fibrosarcomas [ 40 ].…”