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Pathology · Neoplasia: chondroblastoma
Sample itemA 16-year-old boy with open growth plates has knee pain. Radiographs show a well-defined lytic lesion with a sclerotic rim in the proximal tibial epiphysis. Histology shows polygonal cells with grooved nuclei, scattered giant cells, pericellular chicken-wire calcification, and S-100 positivity. What is the diagnosis?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
C. Chondroblastoma
Chondroblastoma is a benign cartilage-forming tumour of the epiphysis in adolescents before physeal closure, with chondroblasts showing nuclear grooves, giant cells and chicken-wire calcification. Giant cell tumour occurs mainly after the growth plate closes and lacks cartilage matrix.
Option by option
A. Osteoblastoma
Osteoblastoma is a bone-forming tumour of the posterior spine elements with osteoid, not an epiphyseal chondroid lesion.
B. Giant cell tumour of bone
Giant cell tumour of bone occurs in skeletally mature adults and does not show chondroid calcification.
C. Chondroblastoma (correct)
Correct. Epiphyseal location in an adolescent, S-100 positive chondroblasts and chicken-wire calcification identify chondroblastoma.
D. Clear cell chondrosarcoma
Clear cell chondrosarcoma is a rare low-grade malignancy of adults with clear cells, not an adolescent tumour with a sclerotic rim.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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