Chondroma

Chondroma (from the Greek. chondros - cartilage) - benign cartilage of the bone tumor is mostly manifested in both sexes and different age, in the form of multiple and single units. The development of gondrom associated with dysplasic formation of bone in the process encontrarnos of ossification. Therefore, there is chondroma often near encontrarnos bone growth.
Pathological anatomy. The point is that chondroma is either well separated single node rounded with a smooth surface, or merged several small units; in the latter case, the tumor has a bumpy surface.
Fabric chondroma in the context of the vitreous, translucent, has a typical view of hyaline cartilage. Separate small units chondroma separated layers of fibrous tissue.
Histologically, chondroma built on the Mature hyaline cartilage, differing from it only structural ativismo: areas rich in cartilage cells, alternate with areas rich in the main substance that cells are randomly, the size and shape of their diverse (Fig. 1). On the periphery of chondroma is located capsule, reminiscent of the structure of perichondrium; sometimes even formed bone capsule. Less common chondroma, which is dominated by small rounded or slightly elongated cells (Fig. 2). The basic substance in such chondroma less, and it is not as dense. Chondroma of this type are not clearly delimited and may even have infiltrating growth. If cell proliferation significant, and infiltrating the growth pronounced, say proliferating handsome. Histological diagnosis of proliferating chondroma should alert for possible recurrence and zlokacestvennoe.
The clinical picture. Multiple chondroma strike predominantly peripheral limb bones, sometimes separate large bones. Solitary of chondroma, on the contrary, there are usually in large tubular and only occasionally in the peripheral bones. When multiple chondroma - enchondroma - because deep in their location in the bone there is sometimes pronounced disfigurement fingers. Separate education, eccentric located in the bones and growing in the direction of the surrounding soft tissues, called chandramani. External limb deformities often comes with this type of tumor, characterised by its large size of individual tumor sites. The tumor may grow slowly for almost the entire life of the patient. With significant development chondroma spread to almost the entire area of the bone.
Multiple enchondroma peripheral bones, despite their rapid growth, remain generally benign. Solitary same chondroma large tubular bones tend to malignancy, i.e., to the transition to the chondrosarcoma (see).
Clinically of chondroma appear knotted deformation of affected areas bones, skin over which not soldered with the tumor. When malignancy single chondroma patients experience significant pain, growing tumors, and sometimes the motor function of the leg in a nearby joint.
X-ray picture of multiple gondrom so characteristic that can be called pathognomonic (Fig. 3). Basic radiological features common to multiple and single gondrom: enlightenment shadow of bone substance, expansion of bone marrow space, curved shear longitudinal axis of the bone thinning and bloating cortical bone, sometimes even complete disappearance, areas of calcification in the background of the changed bones. Radiographically recognizes the violation of the integrity of the cortical layer and additional suction patterns already changed bones and fan-shaped shadow periosteal overlays indicate a malignancy that initially benign tumors (Fig. 4). Break the circuit thinning of the cortical layer multiple chondroma is not a sign of their zlokacestvennoe. More reliable criterion of zlokacestvennoe of gondrom should be considered as clinical guidelines on the steady growth of the tumor and growing pains.
Differential diagnosis is required only when the solitary handsome. This should be taken into account bone cyst and giant cell tumor. The difficulties of differential diagnostics may require in certain clinical indications biopsies. In addition cartilaginous tumors that develop in the bones, known chondroma various soft tissues (in articular capsule, in a separate organs, glands)arising from the so-called lost complexes cartilage.
In connection with the possibility of zlokacestvennoe of solitary chondroma when establishing this diagnosis are direct indications to radical surgery as a preventive measure. Surgery in multiple chondroma is usually because of interference and limitation of mobility of limbs and for cosmetic reasons.

Fig. 1. Chondroma resembling Mature hyaline cartilage.
Fig. 2. Chondroma of small elongated cells.
Fig. 3. Pathognomonic picture of multiple gondrom brush.
Fig. 4. Destruction of the femur with infringement of an integrity of the cortical layer with a malignancy of solitary chondroma.