儿童和青少年骨嗜酸性肉芽肿的影像学表现及病理基础  

Eosinophilic granuloma of bone：imaging manifestations and its pathological basis

作　　者：祁佩红[1] 史大鹏[2] 李四保[3] 薛鹏[1] 宋继安 吴珂[1] 

机构地区：[1]郑州人民医院医学影像科,河南郑州450012 [2]河南省人民医院医学影像中心 [3]郑州大学第三附属医院儿科

出　　处：《实用放射学杂志》2015年第8期1344-1347,共4页Journal of Practical Radiology

摘　　要：目的：探讨儿童及青少年骨嗜酸性肉芽肿（EGB）的影像表现及病理基础。方法回顾性分析经手术病理确诊的29例EGB 的 X 线平片、CT、MRI 及其病理表现。结果29例中24例单发病灶,5例多发病灶。颅骨表现为侵犯颅骨内外板、边界清楚的骨破坏,出现“双边征”“斜坡征”；长骨主要表现为溶骨性骨质破坏,边界清晰,部分边缘硬化,见层状骨膜反应及“袖套征”；椎体表现为楔形或扁平椎改变,可伴有梭形软组织肿胀及脊髓受压；骨盆、锁骨、肩胛骨等扁骨及不规则骨表现缺乏特异性,MRI 示邻近骨髓水肿、周围软组织肿胀有一定特点。EGB 病理上表现为朗格汉斯组织细胞增生和炎性细胞浸润。结论 EGB 的影像表现具有一定特异性及病理基础,但少见部位病灶缺乏影像特征,仍应根据临床、病理、影像相结合进行诊断。Objective To investigate the imaging appearrances and pathological basis of eosinophilic granuloma of bone （EGB）in children and adolescents.Methods X-ray,CT,MRI and pathologic data in 29 cases of EGB which diagnozed by pathology were ret-rospectively analyzed.Results In these 29 cases,24 were solitary lesion and 5 with multiple lesions.The lesions in skull were well defined osteolytic destruction,distinct margin within inner and outer plate involved,as double contour sign and slope sign.The le-sions in limbs showed well defined osteolytic destruction,distinct margin,some reactive osteo-sclerosis,lamellar periosteal reaction and muff sign.The lesions in vertebrae showed well defined typical wedge shape or platyspondyl.Soft tissue swelling and spinal compression could be found in some cases.EGB in uncommon site such as pelvis,clavicle,scapula and irregular bone manifestations showed not specific.MRI showed certain characteristics on adjacent bone marrow edema and swelling of the soft tissue around.On pathology,EGB showed hyperplasia of Langerhans/ cell and infiltration of inflammatory cell.Conclusion There are some specific imaging features of EGB with special pathological basis.But at uncommon sites EGB lacks of specific imaging feature.Combination of the clinic,pathology and imaging can improve the diagnosis accuracy.

关 键 词：骨嗜酸性肉芽肿 计算机体层成像 磁共振成像 病理学 

分 类 号：R681[医药卫生—骨科学]