Chordoma. Cytomorphologic findings in 14 cases diagnosed by fine needle aspiration

Acta Cytol. 2003 Mar-Apr;47(2):202-8. doi: 10.1159/000326505.


Objective: To review the clinical and cytomorphologic features of 14 chordomas diagnosed by fine needle aspiration biopsy (FNAB) at our institution.

Study design: The cytology files from January 1985 to February 2000 at Mayo Clinic, Rochester, Minnesota, U.S.A., were searched for all cases diagnosed as chordoma by FNAB. Clinical, radiographic and cytomorphologic findings of each case were reviewed.

Results: Ten males and four females (mean age, 55 years; range, 14-78) had tumors involving the sacrum (8), clivus (3) and vertebrae (lumbar, 2; cervical, 1). Pain was the presenting symptom in 11 patients. Most smears (82%) were cellular with a fibrillary background. Chondroid matrix was recognized in nine cases. Small, epitheliallike cells constituted the predominant cellular component in nine cases. Cells with clear, vacuolated cytoplasm were seen in almost 'every case; however, true physaliferous cells were rare. Mitotic figures were seen in four cases, binucleation in six and multinucleated giant cells in seven. Needle biopsies contained diagnostic material in all cases. Of the nine patients with follow-up (mean, 57 months; range, 3-184 months), three patients were alive and free of disease, five were alive with disease, and one was dead of disease at this writing.

Conclusion: Because various cytologic presentations and overlapping cytologic features occur between chordoma, chondrosarcoma and metastatic clear cell carcinoma, it is important to recognize the various appearances of chordoma in FNAB.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Biopsy, Needle
  • Cervical Vertebrae / diagnostic imaging
  • Cervical Vertebrae / pathology*
  • Chordoma / diagnostic imaging
  • Chordoma / pathology*
  • Chordoma / therapy
  • Epithelial Cells / pathology
  • Female
  • Humans
  • Lumbar Vertebrae / diagnostic imaging
  • Lumbar Vertebrae / pathology*
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Prognosis
  • Radiography
  • Reproducibility of Results
  • Sacrum / diagnostic imaging
  • Sacrum / pathology*
  • Skull Base Neoplasms / diagnostic imaging
  • Skull Base Neoplasms / pathology*
  • Skull Base Neoplasms / therapy
  • Spinal Neoplasms / diagnostic imaging
  • Spinal Neoplasms / pathology*
  • Spinal Neoplasms / therapy
  • Survival Rate