论文部分内容阅读
目的探讨软骨黏液样纤维瘤的临床病理特征、组织起源、影像学表现、诊断与鉴别诊断。方法回顾性分析3例软骨黏液样纤维瘤的临床及病理资料,观察其组织形态特征,并复习相关文献。结果患者男性2例,女性1例,平均年龄30岁(17~49岁);病变均位于长骨。临床主要表现为无痛性肿块或运动后疼痛。镜下肿瘤呈特征性的分叶状结构,小叶中央细胞稀疏,富含黏液样基质,瘤细胞短梭形或星芒状,有向软骨细胞分化的倾向;小叶周边富于细胞,由纤维母细胞样梭形细胞、圆形成软骨细胞样细胞和良性破骨巨细胞构成。其中1例合并动脉瘤样骨囊肿。免疫组化示肿瘤细胞vimentin和S-100(+),SMA局灶(+)。结论软骨黏液样纤维瘤较少见,可能为软骨源性肿瘤。诊断应结合临床资料和影像学表现,并需与多种良、恶性骨肿瘤鉴别。肿瘤局部复发少见,宜采取保守治疗。
Objective To investigate the clinicopathological characteristics, histological origin, imaging findings, diagnosis and differential diagnosis of myxomatous fibroma in cartilage. Methods The clinical and pathological data of 3 cases of myxomatous fibroma of cartilage were retrospectively analyzed. The histological features were observed, and the related literatures were reviewed. Results There were 2 males and 1 females, with an average age of 30 years (17-49 years). The lesions were all located in the long bones. The main clinical manifestations of painless mass or pain after exercise. Microscopically, the tumors showed lobulated lobular structure. The centrilobular cells were sparse and rich in myxoid matrix. The tumor cells were short or star-shaped. The chondrocytes tended to differentiate. Like spindle cells, round chondrocyte-like cells and benign osteoclastic giant cells. One case with aneurysmal bone cyst. Immunohistochemistry showed that the tumor cells vimentin and S-100 (+), SMA focal (+). Conclusion Cartilage myxoid fibroids are rare and may be cartilage-derived tumors. Diagnosis should be combined with clinical data and imaging findings, and with a variety of benign and malignant bone tumor identification. Local recurrence of tumor rare, conservative treatment should be taken.