儿童骨良性纤维组织细胞瘤的影像诊断  

Imaging diagnosis of benign fibrous histiocytoma of bone in children

作　　者：陈旺强[1] 卢华君[2] 陈久尊[1] 陈博[1] 周胜法[1] 何家维[1] 程建敏[1] 

机构地区：[1]浙江省温州医科大学第二附属医院放射科,325005 [2]浙江省温州医科大学第二附属医院儿科,325005

出　　处：《中华全科医学》2014年第5期796-798,共3页Chinese Journal of General Practice

摘　　要：目的探讨儿童骨良性纤维组织细胞瘤(benign fibrous histiocytoma,BFH)的临床及影像诊断。方法回顾性分析7例儿童BFH的临床及影像资料。结果 3例BFH发生在股骨干骺端,3例在胫骨干骺端,1例生在肱骨,临床上患者以局部疼痛为主,持续数月甚至数年(平均5个月),大部分患者疼痛同病理性骨折没有联系,影像上病灶呈分叶状溶骨性破坏,其内可见骨性分隔,边缘大部分有厚薄不一的硬化边,或没有硬化边,本组病例均位于长骨干骺端,均局限于骨内,无骨膜反应及软组织肿块,1例术后复发。结论 20岁以下BFH患者可能被低估了。儿童及青少年患者影像表现类似但有别于非骨化性纤维瘤伴不可解释的疼痛应该考虑为骨BFH。Objective To study the clinical and imaging diagnosis of benign fibrous histiocytoma（BFH） of bone in chil- dren. Methods Clinical and imaging findings of 7 patients with BFH of bone were analyzed retrospectively. Results BFH occurred in the distal femoral metaphysis （ n = 3 ）, tibial metaphyseal （ n = 3 ） and humerus metaphyseal （ n = 1 ）. The local pain lasting for months, even years （mean 5 months）, was the most common complaint of patients. The pains were not associated with pathological fracture. The focuses presented osteolytic destruction with a lobular arrangement, with the bone separation in them,with or without harden edge. The lesions were lytic and sharply demarcated with a sclerotic rim and fine trabeculations. The reported cases were located in the metaphysis of the long bones. The tumour was restricted to bone,without periosteal or soft tissue reaction. One case was with recurrence. Conclusion Benign fibr~,as histiocytoma is probably underestimated among patients less than 20 years of age. This diagnosis should be considered in any child or teenager who is similar to but different from the non-ossifying fibroma accompanied by unexplainable pain or a rapid grow- ing.

关 键 词：儿童 骨肿瘤 骨纤维组织细胞瘤 体层摄影术 X线计算机 磁共振成像 

分 类 号：R738.1[医药卫生—肿瘤] R445[医药卫生—临床医学]