奇异性骨旁骨软骨瘤样增生5例临床病理学分析

发布时间：2018-04-15 14:51

  本文选题：骨肿瘤 + 奇异性骨旁骨软骨瘤样增生　； 参考：《临床与实验病理学杂志》2016年09期

【摘要】：目的探讨奇异性骨旁骨软骨瘤样增生(bizarre parosteal osteochondromatous proliferation,BPOP)的临床影像学和病理组织学特征、鉴别诊断、治疗及预后。方法对5例BPOP进行HE染色,并进行相关文献复习。结果 5例BPOP患者发病年龄17~48岁,无性别差异,均感觉肿痛不适就诊,病变位于四肢长、短管状骨。X线示宽基底的边界清晰的高密度肿块,起源骨膜下完整的骨皮质,病变部位与附着骨的骨髓腔亦不相通,其中1例伴附骨的骨皮质轻度破坏。镜下见主要由软骨、骨和纤维组织无规则排列而成,轻度异型的软骨细胞可伴大部分钙化软骨,即多形性骨小梁中的"蓝骨";骨小梁周围被覆无异型的骨母细胞,骨小梁间有大量的血管、纤维组织增生。结论 BPOP是一种罕见的、良性的骨软骨瘤样病变,术后高复发性,无转移,恶变罕见,需结合影像学与病理组织学特点进行诊断,易误诊,需与骨旁骨肉瘤、软骨肉瘤、骨化性肌炎等鉴别。
[Abstract]:Objective to investigate the clinical and histopathological features, differential diagnosis, treatment and prognosis of singular paracondromatoid parosteal osteochondromatous proliferation.Methods 5 cases of BPOP were stained with HE and the related literatures were reviewed.Results the age of onset of 5 BPOP patients was 1748 years old. There was no difference in sex. All patients were ill with pain and swelling. The lesions were located in long limbs, short tubular bone. X ray showed a clear high density mass with wide basal margin, and originated from the intact bone cortex under periosteal.There was no connection between the site of the lesion and the medullary cavity of the attached bone, including one case with slight destruction of the bone cortex attached to the bone.Under the microscope, it was found that cartilage, bone and fibrous tissue were arranged irregularly, and mild abnormal chondrocytes could be accompanied by most calcified cartilage, that is, "blue bone" in the pleomorphic trabecular bone, and there were no abnormal osteoblasts around the bone trabeculae.There are a large number of blood vessels between trabeculae and fibrous tissue hyperplasia.Conclusion BPOP is a rare and benign osteochondromatoid lesion with high recurrence, no metastasis and rare malignant change. It is easy to be misdiagnosed with osteosarcoma and chondrosarcoma in combination with imaging and histopathologic features.Differentiation of ossifying myositis.
【作者单位】： 安徽省宿州市立医院病理科;蚌埠医学院病理学教研室;
【分类号】：R681
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本文编号：1754578