膝关节色素沉着绒毛结节性滑膜炎的临床病理分析  

Clinical Pathological Analysis of Pigmented Villonodular Synovitis of the Knee Joint

作　　者：巫娟[1] 徐钢[2] 傅静[2] 

机构地区：[1]四川省骨科医院病理科,四川成都610072 [2]四川省人民医院病理科,四川成都610072

出　　处：《四川医学》2017年第9期1010-1013,共4页Sichuan Medical Journal

摘　　要：目的探讨膝关节色素沉着绒毛结节性滑膜炎(pigmented villonodular synovitis,PVNS)的临床病理特征。方法回顾性分析27例膝关节PVNS的临床病理资料并复习相关文献,获取随访患者预后信息。结果本组PVNS患者平均年龄34.7岁,女性多于男性,病程以3个月至1年者居多,均因膝关节肿胀、疼痛就诊。镜下均包含绒毛、含铁血黄素沉着及单核滑膜细胞构成的肿瘤性结节三种形态学改变。滑膜呈乳头状、绒毛状增生,单核滑膜细胞核圆或卵圆形,大小及形态较一致,其间可散在有破骨细胞样多核巨细胞。含铁血黄素多少不一,散在或成团出现。除此之外还可见泡沫细胞、淋巴细胞浆细胞浸润。结论 PVNS好发于膝关节,术前MRI检查有助于诊断,虽为良性病变但却易复发,结合临床及影像学资料可提高该病的诊断,并且注意与其他疾病的鉴别诊断。Objective To investigate the clinical pathological features of pigmented villonodular synovitis （Pigmentedvillonodularsynovitis, PVNS） of the knee joint. Methods The clinical and pathological data of 27 cases of PVNS of knee joints were analyzed retrospectively. The related literatures were reviewed and the prognosis information of the follow-up patients was obtained. Results The average age of PVNS patients in this group was 34. 7 years, and the amount of women was more than men. The course of disease was mostly 3 months to one year. All of them were admitted to the hospital due to swelling of the knee and pain. Micro- scopically, there were three morphological changes, including villous villi, deposition of hemosiderosis and tumor nodules formed by mononuclear synovial cells. Synovial membrane was hyperplasia of papillary and villous, the nucleus of mononuclear synovial cells were round or oval with consistent size and shape, which maight be scattered in osteoclast like multinucleated giant cells. There were different amounts of hemosiderosis, scattered or present in clumps. In addition, infiltration of foam ceils, lymphocytes and plasma ceils could also be seen. Conclusions PVNS occurs commonly in the knee joints, and preoperative MRI examination is helpful for the diagnosis of it. Although PVNS is a benign lesion,it is easy to recur. Combined with clinical and imaging data, we can im- prove our diagnosis of the disease. And we should pay attention to the differential diagnosis of other diseases.

关 键 词：色素沉着绒毛结节性滑膜炎 鉴别诊断 MRI 

分 类 号：R684[医药卫生—骨科学]