补充 X线示：左跖骨骨囊肿

非典型软骨样肿瘤 / 软骨肉瘤（Ⅰ级）

(Atypical cartilaginous tumour / Chondrosarcoma, gradeⅠ)

I cannot appreciate the cells in figure 12 and 13 from the photos provided. What kind of cells are they? Otherwise, it does look like a chondroid tumor. I agree that we should back off for chondroid tumors arising from fingers and toes. So I would think it is most likely an enchondroma, assuming those cells in figure 12 and 13 are reactive fibroblastic cells. If this is a lesion in long bones, we usually will issue a report as "low grade chondroid neoplasm. Clinical correlation is recommended", as it will depend on the radiation image to detect cortical bone destruction to differentiate grade 1 chondrosarcoma from enchondroma.

骨囊肿

 尽管本例软骨细胞有异型，首先要考虑内生软骨瘤。

与长骨和扁骨不同，鉴别手、足小骨的软骨性肿瘤不能仅依靠镜下形态，主要看影像学和临床有无浸润等。