Light and electron microscopic examination of fine‐needle aspirates in the preoperative diagnosis of cartilaginous tumors

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Abstract
Twenty‐eight patients with chondrogenic tumors—2 chondroblastomas, 4 chondromas, 18 chondrosarcomas, 1 clear‐cell chondrosarcoma, and 3 mesenchymal chondrosarcomas—underwent fine‐needle aspiration biopsy (FNAB) in the preoperative investigation. The cytologic features in smears were compared with the histopathologic findings in the surgical specimens; in 14 cases they were also compared with the light and electron microscopic findings in resin‐embedded fine‐needle aspirates. The smears of the vast majority of the classical chondrosarcomas presented features that made possible the FNAB diagnosis of a chondrogenic tumor to be made. In the case of the low‐grade chondrosarcomas in particular, which were poorly or moderately cellular in smears and showed chondroblastic cells often in lacunary structures of hyaline matrix, consideration of the clinical presentation, size, location, and roentgenographic appearance was essential for the diagnosis of chondrosarcoma. On the other hand, the high‐grade chondrosarcomas presented cytologic features that clearly indicated their malignancy and they usually had a myxoid matrix. The possible differential diagnoses that may arise from the FNAB diagnosis of cartilaginous tumors are discussed. The resin‐embedding technique for the light and electron microscopic examination of FNABs. along with the histochemical analysis for the demonstration of sulphated glucosaminoglycans and the immunocytochemistry applied to smears, was found to be of value in the definite diagnosis, especially in the distinction of chondrogenic tumors from chordoma and metastatic mucous‐producing carcinoma.