尽管其特征性的临床病理特征,软骨母细胞瘤可能构成诊断挑战,考虑到它的形态光谱,在有限的活检标本中出现亚诊断的可能性,以及它对其他实体的潜在模仿。最近,描述了大多数软骨母细胞瘤的特征性H3F3B突变,这导致H3.3K36M作为相应的诊断免疫组织化学标记。本研究是对26例软骨母细胞瘤的免疫组织化学特征的评估,包括DOG1和H3.3K36M免疫染色。H3.3K36M免疫染色分级为1+,2+和3+在染色强度方面。男性17例,女性9例(M:F=1.8:1),年龄7至34岁(平均=16.7,中位数=16)。最常见的位置是肱骨近端(8,30.7%),其次是胫骨近端(5,19.2%),股骨远端(3,11.5%),股骨近端(3,11.5%),骨盆(2,),其次是胫骨远端,跟骨,胸骨上段,肩胛骨,还有D9椎骨,在一个案例中,分别。18例(69.23%)肿瘤表现出所有经典的组织病理学特征。免疫组织化学,肿瘤细胞S-100P阳性(19/22,86.3%),DOG1(局灶性至斑片状)(21/2391.3%),和H3.3K36M(26/26,100%)。H3.3K36M在其他肿瘤中测试,构成软骨母细胞瘤的诊断模拟,比如骨巨细胞瘤,软骨粘液样纤维瘤,和腱膜巨细胞瘤,呈阴性染色。六个肿瘤,最初诊断为软骨母细胞瘤在阴性H3.3K36M免疫染色的帮助下被重新分类为其他实体。本研究加强了H3.3K36M作为诊断软骨母细胞瘤的高度敏感和特异性标志物,包括小活检,以及具有可变组织病理学特征的罕见肿瘤部位。DOG1还可用于在临床放射学背景下加强软骨母细胞瘤的诊断,特别是在缺乏H3.3K36M免疫染色的实验室。然而,其染色模式是可变的。
Despite its characteristic clinicopathological features, chondroblastoma may pose a diagnostic challenge, given its morphological spectrum, potential for subdiagnostic appearances in limited biopsy specimens, and its potential mimicry of other entities. Recently, a characteristic H3F3B mutation underlying most chondroblastomas was described, which led to the identification of H3.3K36M as the corresponding diagnostic immunohistochemical marker. The present study is an evaluation of immunohistochemical features of 26 chondroblastomas, including
DOG1 and H3.3K36M immunostaining. H3.3K36M immunostaining was graded as 1+, 2+ and 3+ in terms of staining intensity. There were 17 males and 9 females (M:F = 1.8:1) with ages ranging from 7 to 34 years (average = 16.7, median = 16). The most common location was proximal humerus (8, 30.7 %) followed by proximal tibia (5, 19.2 %), distal femur (3, 11.5 %), proximal femur (3, 11.5 %), pelvis (2,), followed by distal tibia, calcaneum, upper sternum, scapula, and D9 vertebra, in a single case, respectively. Eighteen (69.23 %) tumors displayed all the classic histopathological features. Immunohistochemically, the tumor cells were positive for S-100 P (19/22, 86.3 %),
DOG1 (focal to patchy) (21/23 91.3 %), and H3.3K36M (26/26, 100 %). H3.3K36M tested in other tumors, constituting diagnostic mimics of a chondroblastoma, such as giant cell tumor of bone, chondromyxoid fibroma, and tenosynovial giant cell tumors, showed negative staining. Six tumors, initially diagnosed as chondroblastomas were reclassified into other entities with the help of negative H3.3K36M immunostaining. The present study reinforces H3.3K36M as a highly sensitive and specific marker for diagnosing chondroblastoma, including small biopsies, and in uncommon tumor sites with variable histopathological features.
DOG1 is also useful in reinforcing a diagnosis of chondroblastoma in a clinicoradiological context, especially in laboratories lacking H3.3K36M immunostain. However, its staining pattern is variable.