骨原发性恶性纤维组织细胞瘤影像诊断  

Imaging diagnosis of primary malignant fibrous histiocytoma of bone

作　　者：彭加友[1] 樊长姝 

机构地区：[1]广东省佛山市中医院放射科,广东佛山528000 [2]北京铁路总医院

出　　处：《实用医学影像杂志》2006年第1期30-32,共3页Journal of Practical Medical Imaging

摘　　要：目的探讨骨原发性恶性纤维组织细胞瘤(BMFH)影像表现及诊断要点。方法回顾性分析6例经病理确诊为BMFH的X线、CT及MRI表现。结果4例侵犯单骨,2例侵犯多骨。溶骨型4例,混合型2例。股骨下端3例,肱骨上端1例,楔骨1例,横突1例,共侵犯12个骨骼。6例均有骨及骨皮质明显破坏,以溶骨性破坏为主,2例病灶周围有轻度骨硬化。全部病例均有软组织肿块,巨大肿块2例,局限性肿块4例,1例肿块内可见散在小钙化影。全部病例未见骨膜反应,3例合并病理性骨折。结论原发性BMFH好发于长骨干骺端或骨端,多见于股骨下端及胫骨上端。虫蚀状或大片状溶骨性骨质破坏,巨大软组织肿块,无骨膜反应,是其影像学特点,诊断需密切结合临床和病理。Objective To discuss conventional X -ray and CT and MR findings and diagnosis of primary BMFH. Metlhods The conventional X -ray and CT and MRI findings of 6 patients which were dianosed BMFH in pathology were retrospectively analysed. Results The lesions involved single bone in 4 cases and multiple bone in 2 eases. The lesions were osteolytic in 4 cases and mixed in 2 cases. The lesions involved distal femur in 3 cases and proximal humerus in 1 case and cuneate bone in 1 case and transverse process in 1 case. The lesions involved 12 bones in all. The lesions were osteolytic and show an aggressive growth with cortical destruction but without periosteal reactions in all cases and mild sclerosis in 2 cases and pathologic fractures in 3 cases. Soft tissue masses（including large masses in 2 cases and localized shape in 4 cases） were observed in all cases. The little calcification was found in 1 case. Conclusions BMFH usually involved metaphysis or extremities of long bones. The distal femur or proximal humerus are the most frequently involved. Imaging character of BMFH is moth - eaten permeative or extensive osteolysis with a large soft - tissue mass but without periosteal reaction. Diagnosis of BMFH should be combined with clinical and pathological data.

关 键 词：骨恶性纤维组织细胞瘤 X线摄影 计算机断层摄影 磁共振成像 

分 类 号：R738.1[医药卫生—肿瘤]