软骨黏液样纤维瘤3例临床病理观察  

Clinicopathological features of chondromyxoid fibroma: a study of 3 cases

作　　者：陈铜兵[1] 赵伟[1] 钱伟明 田波[1] 张大川[1] 谈炎[1] 鲁常青[1] 

机构地区：[1]常州市第一人民医院病理科,江苏常州213003 [2]常州市武进中医院病理科,江苏常州213101

出　　处：《诊断病理学杂志》2014年第8期480-483,共4页Chinese Journal of Diagnostic Pathology

摘　　要：目的探讨软骨黏液样纤维瘤的临床病理特征、组织起源、影像学表现、诊断与鉴别诊断。方法回顾性分析3例软骨黏液样纤维瘤的临床及病理资料，观察其组织形态特征，并复习相关文献。结果患者男性2例，女性1例，平均年龄30岁（17—49岁）；病变均位于长骨。临床主要表现为无痛性肿块或运动后疼痛。镜下肿瘤呈特征性的分叶状结构，小叶中央细胞稀疏，富含黏液样基质，瘤细胞短梭形或星芒状，有向软骨细胞分化的倾向；小叶周边富于细胞，由纤维母细胞样梭形细胞、圆形成软骨细胞样细胞和良性破骨巨细胞构成。其中1例合并动脉瘤样骨囊肿。免疫组化示肿瘤细胞vimentin和S-100（＋），SMA局灶（＋）。结论软骨黏液样纤维瘤较少见，可能为软骨源性肿瘤。诊断应结合临床资料和影像学表现，并需与多种良、恶性骨肿瘤鉴别。肿瘤局部复发少见，宜采取保守治疗。Objective To investigate the clinical and pathological characteristics, histogenesis, radiographic findings, diagnosis and differential diagnosis of chondromyxoid fibroma. Methods Clinical and pathological data of 3 chondromyxoid fibroma eases were analyzed retrospectively. We observed the histomorphological feaures and reviewed pertinent literatures. Results Among 3 cases, 2 were males and one was female and mean age was 30 years （ranged 17 -49 years）. The 3 cases were all located at long bones. The most common presentations were a mass and bone pain. The lesions often had a lobular pattern. The central area of the lobule tended to be less cellular and mainly consisted of mucoid substance scattered in which were generally spindled to stellate cells. These cells had tendency to cartilage differentiation. The lobules tended to be more cellular at their periphery. This area contained spindle cells, round chondroblast, multinucleate giant cells. One case complicated with aneurysmal bone cyst. The immunohistochemical studies showed different staining of the tumor cells for vimentin, S-100 and SMA. Conclusion Chondromyxoid fibroma is rare and probably has a cartilage origin. The clinical and radiologic findings must be known for differential diagnosis from other bone tumors. The tumor has low recurrence rate and conservative therapy is the treatment of choice.

关 键 词：软骨黏液样纤维瘤 骨肿瘤 病理学 鉴别诊断 

分 类 号：R738.3[医药卫生—肿瘤]