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目的分析颌外牙骨质样瘤的临床、X线表现及病理特点。方法10例颌外牙骨质样瘤患者,包括我院诊治的3例及国外文献7例,均经手术和病理证实。结果大多发生于男性儿童或青少年的骨干骺端或近干骺端,位于股骨近端5例,胫骨近端1例,胫骨远端2例,肱骨近端1例及掌骨基底1例。其组织学特点类似颌内牙骨质瘤,是由孤立及聚合的牙骨质样小体和间质组成。牙骨质样小体既不同于骨样组织,又区别于颌内的牙骨质及牙骨质瘤。电镜下牙骨质样小体是含有不规则矿物小体的无细胞性胶原原纤维聚集体。诊断依靠病理检查。手术是治疗的有效办法。多采用搔刮植骨,生长活跃者可行瘤段骨截除,自体骨或异体骨移植。结论此瘤可能来自多潜能间叶组织,具有向间叶性牙源组织分化的倾向和能力。
Objective To analyze the clinical, X-ray findings and pathological features of maxillofacial cementless osteoma. Methods Ten cases of maxillofacial osteohistiocytoma, including 3 cases diagnosed and treated in our hospital and 7 cases of foreign literature, were confirmed by operation and pathology. The results mostly occurred in the metaphysis or near metaphysis of male children or adolescents. There were 5 cases of proximal femur, 1 case of proximal tibia, 2 cases of distal tibia, 1 case of proximal humerus and 1 case of metacarpal base. Its histological features are similar to maxillary odontooblastomas, which are composed of isolated and aggregated cementoid bodies and interstitial tissue. Cementum-like body is different from the bone-like tissue, but also different from the cementum and cementum. Under electron microscopy, cementoid vesicles are acellular aggregates of collagen fibrils with irregular mineral bodies. Diagnosis depends on the pathological examination. Surgery is an effective treatment. More use of scraping bone grafting, active growth of tumor feasible section of bone, autologous bone or allograft. Conclusion The tumor may be from pluripotent mesenchyme and has the tendency to differentiate into mesenchymal dental tissues.