低级别中央型骨肉瘤的临床、影像学和病理学特点(附2例)  

Clinicopathologic study of low grade central osteosarcoma:2 cases report and the literature review

作　　者：程虹[1] 张传山[1] 沈万安[2] 张静[1] 马福成[1] 

机构地区：[1]第四军医大学西京医院病理科,陕西西安710032 [2]第四军医大学唐都医院全军骨肿瘤研究所,陕西西安710038

出　　处：《现代肿瘤医学》2008年第7期1215-1217,共3页Journal of Modern Oncology

摘　　要：目的:探讨低级别中央型骨肉瘤(Low grade central osteosarcoma)的临床、影像学和病理学特点。方法:应用光镜观察2例成人低级别中央型骨肉瘤的病理组织学特点,结合临床、影像学资料分析和国内外文献回顾,讨论低级别中央型骨肉瘤的临床、影像和病理学特点以及诊断和鉴别诊断要点。结果:低级别中央型骨肉瘤发病年龄较普通型骨肉瘤稍大,多为青壮年,病史较长;病变多位于长骨干骺端,特别是股骨远端和胫骨近端,最好发于股骨;影像学检查可见程度不等的骨质破坏;组织学改变没有特征性,类似于良性骨肿瘤或瘤样病变,但有明确的瘤组织浸润,替代骨小梁间的骨髓脂肪组织。常误诊为纤维结构不良等良性病变,骨皮质破坏和软组织肿块是重要的鉴别诊断线索。结论:低级别中央型骨肉瘤的诊断强调组织病理学结合临床和影像学,可以避免误诊。Objective： To discuss the histological and clinical features of low grade central osteosarcoma in combination with the literature review. Methods：Two cases of low grade central osteosarcoma were analysed histologically in combination with clinical and radiographic findings. Results：Cortical destruction is the most convincing radiographic feature. Histologically, the tumor was composed predominately of a centrally located osteocartilaginous component and a peripheral, non - osseous fibrous component. The former was characterized by a complex interanastomosing pattern of woven - bone trabeculae with small osteocytes and a minor cartilaginous element. The intratrabecular stoma was consisted of benign - appearing fibrublasts. The peripheral fibrous part was characterized by fascicular and interlacing proliferations of spindle ceils with mild atypia, rare mitosis and low to moderate cellularity. Conclusion：Low grade central osteosarcoma should be distinguished from other bone - forming tumors or tumor - like lesions. Clinic and radiology are complementary for confirming the diagnosis.

关 键 词：骨肉瘤 低级别 临床病理学 

分 类 号：R738.1[医药卫生—肿瘤]