目的 :通过骨巨细胞瘤组织及原代培养细胞与其超微形态学观察 ,了解该肿瘤的体外生长行为、特点及细胞类型 ,进一步探讨其组织来源。方法 :对收集到的 8例切除或刮除骨巨细胞瘤标本进行了原代培养。所有标本术前均未接受放疗或化疗 ;术后经病理证实 ,实体瘤及培养细胞均按常规方法制备标本 ,透射电镜观察。结果 :本组原代培养成功 6例 ,培养细胞从形态上主要可见到多核巨细胞、梭形的单个核细胞、单个核吞噬细胞样细胞。电镜观察发现无论是组织样本还是细胞样本 ,单个核细胞与多核巨细胞的形态相似 ,二者的超微结构形态未见明显差异 ;培养细胞与组织样本中所见的瘤细胞形态未见差别 ,而瘤细胞形态与正常间质纤维母细胞完全不同 ,说明培养细胞主要为肿瘤性细胞。结论 :原代培养存活期较长的细胞主要为梭形细胞 ,这些细胞与实体瘤组织中的梭形细胞形态一致 ,支持梭形细胞为骨巨细胞瘤的主质细胞。培养细胞及实体瘤组织巨细胞形态与单个核梭形细胞的形态相似 ,二者均不具单核巨噬细胞系的特点 ,体外长期培养存活的细胞中也有一定数量的多核巨细胞 ,认为骨巨细胞瘤中确实存在肿瘤性巨细胞 ,这些细胞来源于单个核梭形肿瘤细胞的融合 ,否定了许多作者所持巨细胞是该瘤中巨噬细胞的反应性融合的观点 OBJECTIVE : To observe the growth behavior, characteristics and cell types of giant cell tumor of bone and its ultrastructure observation in primary cultured cells and further explore the origin of the tissue. METHODS: Primary cultures of 8 cases of giant cell tumors with bone resected or scraped were collected. All specimens were not subjected to radiotherapy or chemotherapy before surgery. After pathological examination, solid tumors and cultured cells were prepared by routine methods and examined by transmission electron microscopy. Results: The primary culture of this group was successful in 6 cases. The morphology of the cultured cells mainly showed multinucleated giant cells, spindle-shaped mononuclear cells and mononuclear phagocyte-like cells. Electron microscopic observations revealed that both the tissue and cell samples were similar in morphology between mononuclear cells and multinucleated giant cells, and there was no significant difference in the ultrastructure of the two cells. There was no difference in the morphology of tumor cells seen in cultured cells and tissue samples. The tumor cell morphology was completely different from that of the normal interstitial fibroblasts, indicating that the cultured cells were mainly neoplastic cells. Conclusion : The cells with longer survival in primary culture are mainly spindle cells. These cells are consistent with the spindle cell morphology in solid tumor tissue and support spindle cells as the main cells of giant cell tumor of bone. The morphology of giant cells in cultured cells and solid tumors is similar to that of mononuclear spindle cells. Both of them have no characteristics of monocyte-macrophage lineage. There are also a certain number of multinuclear giant cells in long-term cultured cells in vitro. Tumor-bearing giant cells do exist in cell tumors, and these cells are derived from the fusion of single nuclear spindle tumor cells, negating the view that many of the authors’ giant cells are reactive fusions of macrophages in this tumor.