毛细血管扩张型骨肉瘤14例临床病理分析  

Telangiectatic osteosarcoma: a clinicopathologic analysis of 14 cases

作　　者：刘洪洪[1] 黄啸原[1] 

机构地区：[1]北京积水潭医院病理科,100035

出　　处：《中华病理学杂志》2002年第3期213-216,共4页Chinese Journal of Pathology

摘　　要：目的　探讨毛细血管扩张型骨肉瘤的临床、影像及病理学特点及影响预后的因素。方法　收集 14例毛细血管扩张型骨肉瘤患者的临床资料 ,对组织行病理观察 ,并对 12例随访材料进行分析。结果　本组患者男性多见 (9/14 ) ,平均年龄 2 3岁。肿瘤多数位于下肢长管状骨 (10 /14 )。X线片示广泛的单纯溶骨病灶 ,骨皮质虫蚀样破坏 ,4例展现爆发式膨大改变 ,病理性骨折 6例。病理形态学表现 ,肉眼标本类似动脉瘤样骨囊肿 ,为含血的单房或多房囊腔。光镜下 ,含血囊壁及间隔处见高度间变的肿瘤细胞及少量纤细或小片状骨样基质。获随访材料的 12例中 ,7例肺转移病例 6例死亡、1例带瘤存活 ,另 5例无瘤存活。结论　毛细血管扩张型骨肉瘤是少见的、独特的骨肉瘤亚型 ,肿瘤的高度恶性。Objective To investigate the clinicopathologic characteritics and prognosis of telangiectatic osteosarcoma. Methods The clinical and pathological data of 14 cases of telangiectatic osteosarcoma were reviewed. Results Most of these patients were male (9/14). The mean age was 23 years. Most tumors were located in the lower extremities (10/14). The roentgenograms showed a large purely osteolytic lesion. Both medullar and cortical bone were extensively destroyed. The gross specimen showed cystic cavities separated by septa, similar to an aneurismal bone cyst. Microscopically, the septa contained anaplastic cells. A few fine, lace like osteoid were scattered among these sarcomatous cells. 12 patients were followed up from 6 months to 84 months. Of seven patients who had developed pulmonary metastasis, six patients died and one alive with lung metastasis. The remaining five patients survived after operation. Conclusions Difficulties in making an early diagnosis and highly malignant of this disease might be the important factors that affect the prognosis of telangiectatic osteosarcoma.

关 键 词：毛细血管扩张型骨肉瘤 骨肿瘤 骨肉瘤 病理学 临床分析 诊断 

分 类 号：R738.1[医药卫生—肿瘤]