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目的探讨骨旁骨肉瘤(POS)的临床病理特征、诊断与鉴别诊断。方法结合临床资料及影像学所见,分析5例POS的组织病理特点并复习相关文献。结果患者女性4例,男性1例;年龄21~47岁,平均32.2岁。4例病变位于腘窝,致屈膝受阻;1例肿块累及左大腿上端,伴轻度疼痛及肿胀。X线显示广基蘑菇状肿块矿化明显,与骨皮质相连,伴/不伴狭窄的透光带。大体见灰白色肿块呈分叶状或D字形,中央坚硬而周边质软。镜下肿瘤由相对成熟的骨小梁及异型性较小的增生性梭形纤维母细胞构成,这些宽大的骨小梁缺乏骨母细胞衬覆,排列成平行状。结论 POS是一种分化良好的皮质旁骨源性恶性肿瘤。熟悉其形态表现有助于正确诊断。
Objective To investigate the clinicopathologic features, diagnosis and differential diagnosis of para - osteosarcoma (POS). Methods According to the clinical data and imaging findings, we analyzed the histopathological features of 5 cases and reviewed the related literatures. Results There were 4 females and 1 males, ranging in age from 21 to 47 years with an average of 32.2 years. 4 cases of lesions located in the popliteal fossa, resulting in knee flexion; 1 case involving the left upper thigh mass, with mild pain and swelling. X-ray showed broad-based mushroom-like mass mineralization, connected with the cortical bone, with / without narrow light transmission band. Generally see the gray mass was lobulated or D-shaped, the central hard and soft surrounding. Microscopic tumor by the relatively mature trabecular bone and atypia smaller proliferative spindle fibroblasts, the lack of these large trabecular bone cells lining, arranged in parallel. Conclusion POS is a well-differentiated cortical bone cancer. Familiar with its morphological performance will help correct diagnosis.