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Case Reports
- Cytohistologic Features of Chordoma Arising in Thoracic Spine: A Case Report.
- Seung Yeon Ha, Insun Kim, Sung Hye Park, Heum Rye Park
- Korean J Cytopathol. 1995;6(2):199-203.
- 1,373 View
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Abstract
PDF - Chordoma is relatively uncommon tumor comprising 1~4% of primary malignant bone tumors, and believed to arise from the remnants of notochordal tissue. Because of its occurrence in the thoracic spine, we report a case of chordoma in volving the thoracic spine. A 45-year-old male was suffered from chest pain radiating to the back. Chest CT showed a well marginated, round huge mass with multiseptated enhancement at the thoracic spine from T5 to T8 level, After percutaneous needle aspiration, piecemeal resection of the tumor was done. On cytologic smears. two types of neoplastic cells were arranged in sheets and cords in mucinous background. One type of cells consisted of medium sized cells with pink cytoplasm and round nuclei. The other type had voluminous bubbly or clear cytoplasm divided by intracytoplasmic septae imparting a feathery or basket-like appearance. Histologically, the tumor showed lobulated feature divided by fibrous septae and the tumor cells were pink eosinophilic or physaliphorous in morphology. Immunohistochemically, the tumor cells revealed strong positivity for low(AE1) and high (AE3) molecular weight cytokeratins.
- Fine Needle Aspiration Cytology of Cervical Chordoma: A Case Report .
- Kyung Moo Yang, Mee Yon Cho, Soon Hee Jung, Jeong Pyo Bong
- Korean J Cytopathol. 1997;8(1):93-97.
- 1,410 View
- 15 Download
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Abstract
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- A case of cervical chordoma diagnosed by fine needle aspiration is discussed. A 41year-old male was admitted due to dyspnea on neck flexion. Radiologic image revealed a retrotracheal superior mediastinal solid mass. Aspiration cytology showed many clusters of oval or large polygonal cells having abundant eosinophilic or bubbly cytoplasm in an amorphous blue-gray mucoid background. The nuclei were round and showed size variation, coarse granular chromatin, and indistinct nucleoli. Some cells contained brown granular pigments in the cytoplasm. Mitoses were rarely found. The cytoplasm was strongly positive for PAS stain. Immunohistochemical stains using cell block revealed positive reaction for cytokerain, EMA, vimentin, and S-100 protein. The confirmative diagnosis was made by following excisional biopsy. Electron microscopic study revealed large pools of intracytoplasmic glycogen and microfilaments. This is the first case of cervical chordoma diagnosed by aspiration cytology to our knowledge in Korean literature.
- Cytologic Features of the Chordoma: Report of five cases.
- Dong Hoon Kim, Shin Kwang Khang, Gyun Gyub Gong
- Korean J Cytopathol. 2001;12(2):105-110.
- 1,586 View
- 17 Download
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Abstract
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- Chordoma is a rare, clinically and morphologically well characterized tumor, which arises from remnants of the notochord. The majority(60%) occurs in the sacrococcygeal region, with 25% in the clival region, and 15% in the spine. Although most chordomas do not develop metastasis, the long term prognosis is very poor due to local progressive tumor growth and tendency to recur if incompletely excised. The chordoma has characteristic cytologic features which make a preoperative diagnosis possible. We reviewed the cytologic findings of five patients with chordoma(one oropharynx, two clivus, and two sacrum). The patients were three male and two female, aged from 29 to 77 years(mean 60). Of five chordomas, there were local recurrences in two cases and metastasis of lymph node in one case. Four were FNA smears and one was squash smear taken from intraoperative consultation. All five cases show similar cytologic features. The dominating tumor cells were large with round nuclei and pale-stained vacuolated cytoplasm. The small round uniform cells and short spindle- shaped cells were frequently noted. The cells were surrounded by myxoid or mucoid matrix. The chordoma has characteristic cytologic features which make a preoperative diagnosis possible.
- Cytologic diagnosis of a chordoma without physaliferous cells: A case report.
- Yun Hee Jin, Chan Kum Park, Won Mi Lee, Moon Hyang Park
- Korean J Cytopathol. 2001;12(2):131-134.
- 1,732 View
- 19 Download
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Abstract
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- Cytologic features of conventional chordoma have been described and most reports emphasize the presence of large cells with numerous well defined cytoplasmic vacuoles or physaliferous cells. We report fine needle aspiration cytologic (FNAC) findings of a case of chordoma without physaliferous cells. The smear was cellular and composed of large cohesive clusters or individually scattered cells in mucinous background. The round or cuboidal cells had centrally located nuclei with fine granular chromatin, inconspicuous nucleoli, and occasional vacuolated cytoplasm. Mild to moderate pleomorphism was noted. Physaliferous cells are extremely helpful when present in cytologic material, but they are not necessary for diagnosis. Thus clinical history, roentgenographic appearance, and exact location of the lesion are required for the successful interpretation of presacral aspirates together with cytologic findings.
- Cytologic Findings of Chordoma in Fine Needle Aspiration Cytology.
- Han Suk Ryu, Min Suk Kim, Hwa Jung Ha, Jung Soon Kim, Myung Soon Shin, Sunhoo Park, Jin Haeng Chung, Jae Soo Koh, Seung Sook Lee
- Korean J Cytopathol. 2004;15(1):45-51.
- 2,773 View
- 92 Download
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Abstract
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- It is important to recognize the pathognomonic cytologic findings of chordoma, because of overlapping cytologic features between chordoma, chondrosarcoma, myxofibrillary ependymoma, and metastatic adenocarcinoma. We reviewed the cytomorphologic features of 5 cases of chordoma diagnosed by fine needle aspiration cytology at Korean Cancer Center Hospital from 1987 to 2003. Clinical and radiographic findings of each case were reviewed. Four males and one female (29-54 years) had tumors involving the sacrum. Pain was the presenting symptom in 4 cases. The three cases showed moderate to high cellularity. In all cases, typical physaliferous cells with or without cytoplasmic processes were noted. In two cases, the background was myxoid with single scattered cells. Cell clusters showing cord-like arrangement were occasionally seen. The single or clustered cells showed mild cellular pleomorphism with slightly increased nuclear/cytoplasmic ratio. Mitotic figures were not seen. In our review, the recognition of physaliferous cells is the most important feature to diagnose chordoma and to differentiate it from other lesions mimicking chordoma.
Original Article
- Dedifferentiated Chordoma: Report of a case.
- Sang Yong Song, Mi Kyung Kim, Yong Il Kim
- Korean J Pathol. 1993;27(3):256-262.
- 1,621 View
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Abstract
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- Dedifferentiated chordoma is a rare pathologic entity presenting an additional sarcomatous component in otherwise classical chordoma. It has been also emphasized that this neoplasm is classified as a distinct entity because of its different clinical settings and aggressive behavior. Dedifferentiation is a peculiar phenomenon but its histogenesis has remained controversial. A 50-yera-old man developed a huge tumor mass in the retrorectal, presacral area, featured with two histological components. The one was a typical chordoma accounted for approximately 60% of the mass and the other was made up of highly cellular, plemorphic, undifferentiated tumor cells, reminiscent partly to the cells of plemorphic malignant fibrous histiocytoma. Ultrastructural features and immunoreactivity against cytokeratin, S-100 protein and alpha-1-antichymotrypsin in both portions support that histologically different components of this neoplasm derive from the same origin. To our knowledge, this is the first case of dedifferentiated chordoma in Korea.
Case Report
- A Case of Sacrococcygeal Chordoma Diagnosed by Fine Needle Aspiration Biopsy Cytology.
- Ja June Jang, Kyung Ja Cho, Soo Yong Lee
- Korean J Pathol. 1988;22(3):356-359.
- 1,584 View
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Abstract
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- A case of sacrococcygeal chordoma diagnosed by fine needle aspiration is presented. This is a case of a 54-year-old woman who came with coccygeal pain of 5-6 months duration. Aspiration biopsy cytology revealed many nests of cells having abundant bubbly cytoplasm and round to oval variably sized nuclei. The cells had indistinct cytoplasmic borders and many of the cells had cytoplasmic vacuoles. The nuclei had thin regular nuclear membranes, finely granular chromatin and one or two small nucleoli. The cells were generally monotonous, but focally pleomorphic with giant cell formation. Mitotic figures were scanty. The backgroud of the aspirate contained abundant mucinous materal. These findings were typical of those of recorded chordoma cases and the diagnosis was confirmed by a following open biopsy. The patient received 4,000 rads of neutron radiotherapy and has been well till March '88.
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