论文部分内容阅读
目的分析软骨母细胞瘤(CB)的形态学特征、影像学表现、治疗及鉴别诊断。方法应用HE和免疫组化方法对67例软骨母细胞瘤进行病理观察,同时分析其X线平片、CT和MRI的影像学特点。结果本组发生于股骨37例(55.22%),胫骨12例(17.91%),其他少见部位18例(26.87%)。X线表现为一个界限清楚的具有薄硬化边的卵圆形骨质破坏区,呈偏心或中央位于骨骺或骨突。CT示骨质破坏区内有低密度斑点或斑片状钙化、骨膜反应、病变周围软组织肿胀及囊性变。MRI示T1WI以等、低信号为主,T2WI呈混杂信号。软骨母细胞瘤最显著的组织学特点之一是“格子样钙化”(围绕细胞的鸡笼样细微钙化),但比起具有核沟和嗜酸性软骨基质的多角形瘤细胞及灶性坏死,本组仅出现31例(46.27%)。免疫组化示45例S-100();所标记的26例CB中9例D2-40(),11例D2-40(+);除5例瘤细胞Ki-67高表达外,其他均低表达。结论软骨母细胞瘤是软骨少见的良性肿瘤,形态学除了“格子样钙化”外还可见软骨基质的嗜酸性变,免疫组化S-100和D2-40阳性对正确诊断至关重要。
Objective To analyze the morphological features, imaging findings, treatment and differential diagnosis of chondroblastoma (CB). Methods 67 cases of chondroblastoma were observed by HE and immunohistochemistry, and the imaging features of X-ray, CT and MRI were analyzed. Results The group occurred in 37 cases (55.22%) of femur, 12 cases (17.91%) of tibia, and 18 cases (26.87%) of other rare sites. X-ray showed a well-defined thin sclerosis side of the oval bone destruction area, was eccentric or central in the epiphyseal or bony process. CT showed bone destruction of the area with low-density spots or patchy calcification, periosteal reaction, soft tissue lesions around the cystic lesions and changes. MRI showed T1WI to wait, low signal-based, T2WI was a mixed signal. One of the most prominent histological features of chondroblastoma is the “lattice-like calcification” (caged microcalcification around the cells), but compared to polygonal tumor cells with a nuclear groove and eosinophilic cartilage matrix and focal Necrosis, this group only appeared in 31 cases (46.27%). Immunohistochemistry revealed 45 cases of S-100 (); 9 cases of D2-40 () and 11 cases of D2-40 (+) were labeled in 26 cases of CB. Except for the high expression of Ki-67 in 5 cases, Others are low expression. Conclusions Chondroblastoma is a benign tumor with rare cartilage. Morphology is also characterized by eosinophilic changes of the cartilage matrix in addition to the “lattice-like calcification”. Immunohistochemical staining of S-100 and D2-40 is of paramount importance for correct diagnosis.