Nora病影像学与临床病理分析  

Nora's lesion: a clinicopathologic analysis

作　　者：徐嘉雯[1] 尹迎春[2] 俞洵宗 纪常生 冯吉贞[4] 王宏量 XU Jiawen;YIN Yingchun;YU Xunzong;JI Changsheng;FENG Jizhen;WANG Hongliang(Department of Patnology,Radiology,Shandong Provincial Hospital Affiliated to Shandong University,Jinan 250021,P.R.China;Department of Pathology,Central Hospital of Zibocity,Zibo 255036,P.R.China;Department of Pathology,People’s Hospital of Jimo District,Qingdao 266200,P.R.China4.Department of Radiology,Shandong Provincial Hospital Affiliated to Shandong University,Jinan 250021,P.R.China5.Shandong Academy of Occupational Health and Occupational Medicine,Shandong Academy of Medical Sciences,Jinan 250062,P.R.China)

机构地区：[1]山东大学附属省立医院病理科,山东济南250021 [2]山东省淄博市中心医院病理科,山东淄博255036 [3]山东省青岛市即墨区人民医院病理科,山东即墨266200 [4]山东大学附属省立医院医学影像科,山东济南250021 [5]山东省职业卫生与职业病防治研究院山东省医学科学院,山东济南250062

出　　处：《医学影像学杂志》2018年第6期1017-1020,共4页Journal of Medical Imaging

摘　　要：目的探讨Nora病(NL)的临床影像学和病理组织学特征、鉴别诊断、治疗及预后。方法对7例NL进行HE染色,光镜观察,结合文献复习分析其临床影像及病理组织学特点并随访。结果 7例NL发病年龄5～49岁,平均32岁,男性3例,女性4例。病变位于手部者6例,足部1例。X线示骨旁边界清晰的高密度肿块,CT、MRI图像显示病变与附着骨的骨髓腔不相通。镜下见由分化成熟的骨、软骨和纤维3种成分构成。轻度异型的软骨细胞可伴钙化,在HE染色切片上呈蓝色而称为"蓝骨";骨小梁周围被覆无异型的骨母细胞。7例均行手术治疗,1例术后复发。结论 NL是一种好发于手足管状骨的罕见的、有复发倾向的良性增生性病变,有特征性的X线和组织病理学表现,应与骨软骨瘤、骨旁骨肉瘤及甲下外生性骨疣等鉴别。Objective To explore the clinical-radiological and pathological features of the Nora＇s lesion（NL）. Methods The clinical and pathological data of 7 patients with NL were collected. All cases were investigated by light microscopy,and the related literatures were reviewed. Results 7 cases（7 patients,three males,four females） were identified. The average age was32（ from 5 to 49） years. Six cases involved the hand and one the foot. NL was a well-defined parosteal lesion. CT and MRI images showed no cortical/medullary infiltration. Under light microscope,the lesion was mainly composed of three different mature tissues： bone,cartilage and fibrous. The cartilage component may show mild pleomorphic and calcification,and stainsed blue on HE slides,which was characteristically called ＂blue bone＂. The osteoblastic cells lined the trabecular bone surface and show no atypia. All of the 7 cases were treated with surgery initially,and recurrence occurred only in one patients（14. 3%）. Conclusion NL is a rare benign surface osteocartilaginous lesion mainly affecting the tubular bones of the hands and feet with higher rate of recurrence,showing unique imaging and histopathological characteristics. The diagnosis is suspected by imaging characteristic features and is conrmed by histopathology. The differential diagnosis of the NL includes osteochondroma,parosteal osteosarcoma,subungual exostosis,etc.

关 键 词：骨肿瘤 Nora病 影像学 诊断 鉴别诊断 

分 类 号：R738.1[医药卫生—肿瘤] R445[医药卫生—临床医学]