滑膜软骨瘤病14例临床病理分析  

The clinicopathological study of 14 cases of synovial chondromatosis

作　　者：张学东[1] 毛勇[1] 胡艳萍[2] 

机构地区：[1]首都医科大学附属北京潞河医院骨科,101149 [2]首都医科大学附属北京潞河医院病理科,101149

出　　处：《疑难病杂志》2017年第10期1050-1053,F0003,共5页Chinese Journal of Difficult and Complicated Cases

基　　金：北京市通州区科技计划项目(KJ2017CX040-05)

摘　　要：目的探讨滑膜软骨瘤病(SC)的临床病理特征、诊断及治疗,并分析预后。方法收集2005年1月—2016年12月首都医科大学附属北京潞河医院骨科SC 14例,根据病理组织形态学分为普通SC(SC-N)组(11例)和伴有异型软骨细胞的SC(SC-D)组(3例),进行S100和Ki-67蛋白的免疫组织化学染色(IHC),结合临床各项相关指标进行临床病理及SC疾病预后的相关性分析。结果 14例SC患者男6例,女8例,年龄25~64岁。X线及CT示关节腔有多少不等、大小不一的钙化游离体,呈卵圆形或不规则形的稍低密度结节影;组织学表现为滑膜增生,化生的软骨结节周围有纤维组织包绕,可继发钙化和骨化。SC病理组织学:大体表现病变处滑膜增厚、充血,滑膜向表面突起呈绒毛状、息肉状或结节状,SC-N组11例软骨细胞温和,无异型;SC-D组3例软骨细胞增生较活跃,可见到软骨细胞轻~中等程度的核多形性,甚至出现多核。S100呈(+^+++)不同程度阳性表达10例(71.4%);Ki-67均呈阴性表达。术后随访5个月~11年均无复发及恶性变。结论 SC是软骨细胞结节性增生的良性病变,其中软骨细胞可以增生较活跃,并表现出一定程度的异型性,但临床预后未见无复发及恶性变,局部手术切除及术后早期功能锻炼可获得良好效果。Objective To investigate the clinicopathological features,diagnosis and prognosis of synovial chondromatosis （SC）.Methods According to histomorphology,14 cases of SC were collected and divided into normal SC group （SC-N） and SC group with heteromorphic chondrocytes （SC-D）.The expression of S100 and Ki-67 in 14 cases of SC was detected by immunohistochemistry,and the clinicopathological correlations was analyzed with the clinical and follow up data of all SC.Results Of 14 patients with SC,6 were males and 8 females,aged 25-64 years.The imaging of SC mostly showed calcified free body,oval or irregular shape,with the slightly lower density.The synovial membrane was hyperplasia,and metaplasia cartilage wrapped the fibrous tissue can be secondary to calcification and ossification.The positive expression rate of S100 was 71.4% and Ki-67 was all negative in SC.There was no recurrence and malignant transformation of SC in follow up.Conclusion SC is a benign lesion of chondrocyte nodular hyperplasia,in which chondrocytes hyperplasia can be more active and exhibit a certain degree of atypia,but there is no recurrence and malignant transformation of clinical prognosis,local surgical resection and early postoperative functional exercise can be obtained good treatment.

关 键 词：滑膜软骨瘤病 病理学 软骨化生 预后 

分 类 号：R687.3[医药卫生—骨科学]