Figure 2
Patient 2, a 57 year-old woman. CT images reveal a mostly sclerotic lesion with focal areas of lysis, compromising the posterior cortex of L4 (a and b). c: Similar lesion in the thoracic spine (discovered retrospectively, not biopsied); fat is visible inside the lesion. Microscopically, the BNCT component is composed of permeative sheets of cells (H&E, obj. 4, d). e: The cells are adipocyte-like without atypia (H&E, obj 20). f: A minute atypical area surrounded by osteosclerosis; higher magnification (g) reveals spindled notochordal cells with moderate atypia, but without a nodular growth pattern or clear myxoid stroma (H&E, obj 20). This lesion recurred as a classic chordoma (h): cords and strands of tumor cells in a myxoid background with a nodular growth pattern (H&E, obj 10).