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目的探讨儿童骨化性肌炎(MO)的临床病理学特点、诊断与鉴别诊断。方法对1例儿童骨化性肌炎的临床、影像学及病理特征进行观察并复习文献。结果患儿男性,12岁。因外伤后左髋疼痛1个月入院。患儿分别于第1周、第2周及第4周末行左髋部平扫,前两次无阳性发现,第3次可见左髋关节前方占位性病变,呈中央密度较低、外周密度较高的骨性区环绕。进一步行MRI显示左髋关节前方肌肉内占位性病变,相邻骨皮质光滑,两者无关系。手术切除病变并送病理。镜下可见典型的3层带状分布的结构,由内向外分别为增生的纤维母细胞、富于骨母细胞的不成熟骨组织及成熟骨组织。免疫组化:SMA和CD68(+),Ki-67增殖指数为8%,且阳性细胞主要是增生的纤维母细胞。结论骨化性肌炎很少发生在儿童,具有独特的临床表现、影像学改变及病理特征,是一种少见的累及肌肉等软组织的良性非肿瘤性病变,预后良好。
Objective To explore the clinicopathological characteristics, diagnosis and differential diagnosis of ossifying myositis (MO) in children. Methods One case of ossifying myositis in children with clinical, imaging and pathological features were observed and reviewed the literature. Results children male, 12 years old. Left hip pain due to trauma 1 month hospitalization. Children in the first week, the second week and the end of the fourth weekend left plain scan, the first two no positive findings, the third can be seen in front of the left hip joint occupying lesions, showed a lower central density, peripheral density Surrounding the taller bony area. Further MRI showed the left hip anterior muscle mass lesions, the adjacent cortical bone smooth, no relationship between the two. Surgical removal of lesions and sent pathology. Microscopically, a typical three-layer band-like structure was observed. From inside to outside, hematopoietic fibroblasts, immature bone tissue rich in osteoblasts and mature bone tissue were seen. Immunohistochemistry: SMA and CD68 (+), Ki-67 proliferation index was 8%, and the positive cells were mainly hyperplastic fibroblasts. Conclusion Ossification myositis rarely occurs in children with a unique clinical manifestations, imaging changes and pathological features, is a rare involvement of muscle and other soft tissue benign non-neoplastic lesions, the prognosis is good.