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机构地区:[1]河南省洛阳正骨医院正骨研究所
出 处:《中医正骨》1995年第4期5-6,共2页The Journal of Traditional Chinese Orthopedics and Traumatology
摘 要:报告了9例长骨骨化性纤维瘤,男3例,女6例;就诊年龄最小3岁,最大38岁,平均17.22岁;胫骨7例,股骨1例,肱骨1例。临床主要症状表现为局部肿块和疼痛,X线表现为多囊性溶骨性病变,皮质膨胀变薄,无骨膜反在。本组9例中经临床及X线正确诊断者仅1例.结合文献报道的病例分析,发现该病虽有一定特征,但临床误诊率甚高,最易误诊为骨纤维异常增殖症。其误诊原因主要因为该病少见,且与骨纤维异常增殖症极相似;也与该病组织结构表现多样呈渐进发展的特性有关。病理检查是确诊的主要手段,有病理骨折者,要尽早活检,取瘤体中心部织,避免骨折修复反应对诊断的影响。复发病例的病理诊断,要以第1次活检材料为准,排除手术后反应对诊断的干扰。与骨纤维异常增殖症难以鉴别时,应多点取材,了解肿瘤全貌,以其主要在现定性。Nine cases of long bone osteofibroma (LBOF) are reporrted in this paper. This disease is manifested clinically by local lumps and pains and radiologically by polycystic osteolytic lesions,thinned cortex and no periosteal reaction. LBOP is easy to be misdiagnosed as fibrous hyperplasia of bone (FHB) and has a high misdiagnostic rate ,which may be related to its rareness ,similarity to FHB ,variety of pathological morphology ,and gradual progress. The pathological examination should be taken as the main diagnostic means. In pathological fracture, early biopsy should be made,the central part of the tumor should te taken as,the biopsy tissue,avoiding the effec of fracture repair reaction on the diagnosis; in recurrent case,the first biopsy should be taken as the diagnostic basis ,avoiding the intervention of postoperative reaction in the liagnosis;and in difficult differentiation from FHB,multipoint biopsy should be made ,and the main morphological findings taken as the diagnostic basis.
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