PMC10207330_01
Cartilage-like cut surface of the abdominal wall mass.
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F1
The cut surfaces were all cartilage-like with a brittle texture, gray to gray-white color and focal calcification (Figure 1).
The microscopic characteristics and immunochemical phenotype of the recurrent tumor. (A) Cartilage islands were arranged in nodules. (B) Chondrocytes were well differentiated with mild to moderate atypia. (C) A chondrocyte with bizarre nuclei (indicated by the yellow arrow). (D) A bundle of spindle cells was observed next to the cartilage island (indicated by the blue arrow). (E) The nucleus of the spindle cell was cigar shaped [Hematoxylin-eosin staining; Magnification: (A,D) x40, (B-D) x200; Immunochemistry staining; Magnification: x200].
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F2
Microscopically, the vast majority of the neoplasm was composed of well-differentiated cartilaginous islands arranged in lobules (Figure 2A). The chondrocytes were uniform in shape with mild to moderate atypia and were unevenly distributed in the cartilage matrix (Figures 2B, C). Aside from the cartilage islands, a single cluster of spindle cells was observed (Figure 2D). The spindle cells were arranged in bundles and featured cigar-shaped nuclei and eosinophilic cytoplasm (Figure 2E). The strong positivity of P53 in chondrocytes indicated that cartilage islands, although well differentiated, were malignant (Figure 2).
Microscopic characteristics and immunophenotypes of the primary tumor. (A) Spindle cells with cigar-shaped nuclei were arranged in a fascicular pattern. (B) Epithelioid cells with mild to moderate atypia were lined in a lace-like pattern. (C) Coagulative necrosis was frequently seen. (D) Mitoses were easily observed. (E) Tumor cells exhibited mild to moderate atypia [Hematoxylin-eosin staining: (A) x200. (B) x100. (C) x40. (D,E) x400. Immunochemistry staining: x400].
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F3
Sarcomatoid-like spindle cells were arranged in the fasciculus or vortex with cigar-shaped nuclei and sparse eosinophilic cytoplasm under high magnification (Figure 3A). Epithelioid cells with round to ovoid nuclei and prominent nucleoli arranged in cords or small nests were embedded in the edematous and mucinous matrix (Figure 3B). Marked necrosis could be easily observed under low-power microscopy (Figure 3C). The tumor cells showed overall mild to moderate atypia with active mitosis demonstrating over 10/10 HPF (Figures 3D, E).