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Int J Clin Exp Pathol 2011;4(2):169-174

Original Article
Large and round tumor nuclei in osteosarcoma: good clinical outcome

Carlos E. de Andrea, Antonio Sergio Petrilli, Reynaldo Jesus-Garcia, Luiz F. Bleggi-Torres, Maria Teresa S. Alves

Department of Pathology, Universidade Federal de São Paulo, São Paulo, Brazil; Instituto de Oncologia Pediátrica, Grupo de Apoio ao
Adolescente e à Criança com; Câncer/Universidade Federal de São Paulo, São Paulo, Brazil; Department of Orthopedics and Traumatology,
Universidade Federal de São Paulo, São Paulo, Brazil; Department of Pathology, Universidade Federal do Paraná, Paraná, Brazil.

Received January 20, 2011; accepted January 29, 2010; Epub January 30, 2011; published February 15, 2011

Abstract: Osteosarcoma is the most frequent primary malignant bone tumor. Distinct histological features are distinguishable based on the
morphology of the tumor. Differences in nuclei size and shape are often observed in osteosarcoma reflecting its broad histopathological
heterogeneity. This study explores the relevance of two nuclear parameters in osteosarcoma: large area and round shape. Computerized
nuclear morphometry was performed in 56 conventional osteosarcoma preoperative biopsies. The mean patient follow-up time was 35.1
months. Based on the nuclear area, no significant difference (P = 0.09) in overall survival between patients with large (≥ 42.5 μm2) and small (<
42.5 μm2) tumor nuclei was found. However, when cases with large and round nuclei were analysed separately (≥ 42.5 μm2 and coefficient of
nuclear roundness ≥ 0.7), these two parameters together were likely to be a predictive factor (P = 0.05). Osteosarcoma patients with large and
round tumor nuclei had a better outcome than patients with small and polymorphic (ovoid or spindle-shaped) nuclei. In this study, nuclear
morphometry proved to be a useful tool to shed light on the biology of osteosarcoma showing that some morphometric parameters can be
easily applied to help identifying patients with a good prognosis. (IJCEP1101004).

Keywords: Large nuclei, round nuclei, nuclear morphometry, osteosarcoma

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Address all correspondence to:
Maria Teresa S. Alves, MD, PhD
Department of Pathology
Universidade Federal de São Paulo
Rua Botucatu 740
Postal Code: 04023-900
Sao Paulo, Brazil
Phone: +55 11 55727501, Fax: +55 11 55719295