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[目的]探讨骨原发性良性纤维组织细胞瘤(BFH)的影像学表现及其病理特点。[方法]回顾性分析15例经手术病理证实的骨良性纤维组织细胞瘤的影像资料,并将之与手术病理结果对比。[结果]临床以局部疼痛为主。发病部位以四肢长骨居多,单发病变14例,多发病变1例。10例病例行X线检查,11例行CT检查,6例行MRI检查。X线表现大部分为中央型溶骨性破坏,单房或多房状,部分病灶膨胀,皮质断裂。CT显示病灶边界清楚,周围可伴有或不伴有硬化边缘,硬化缘厚薄不均。MRI显示所有病例在T1WI上类似肌肉信号,4例T2WI及T2WI压脂像上见斑片状或条索状低信号区,2例病灶整体呈稍高信号。3例病灶穿破骨皮质向外侵犯,周缘软组织见反应性水肿。术中见瘤体为灰黄色或褐黄色组织,镜下由漩涡样排列的梭形纤维母细胞构成,其间散在多核巨细胞和泡沫细胞,无成骨组织。[结论 ]骨良性纤维组织细胞瘤的影像表现有一定的特点,也反映了其病理改变,综合各种影像表现并结合临床特点,多数典型病例可作出诊断。
[Objective] To investigate the imaging features and pathological features of primary benign fibrous histiocytoma (BFH). [Methods] The imaging data of 15 cases of benign fibrous histiocytoma confirmed by surgery and pathology were retrospectively analyzed, and compared with the pathological results. [Results] The main clinical local pain. The main part of the disease to the long bones of the limbs, single lesions in 14 cases, multiple lesions in 1 case. X-ray examination was performed in 10 cases, CT examination in 11 cases and MRI in 6 cases. X-ray showed most of the central osteolytic destruction, single or multiple room, part of the expansion of the cortex rupture. CT showed a clear boundary of the lesion, with or without cirrhosis around the edge, uneven thickness of the sclerosis. MRI showed similar muscle signals on T1WI in all cases, and patchy or cord-like low signal areas in 4 cases of T2WI and T2WI fatal images. The two lesions showed a slightly higher signal overall. 3 cases of lesions penetrated through the cortical bone, peripheral soft tissue see reactive edema. Surgery, see the tumor was gray or brownish yellow tissue, microscopic arrangement by the vortex spindle fibroblasts, interspersed in the multinucleated giant cells and foam cells, no osteogenic tissue. [Conclusion] The imaging features of benign fibrous histiocytoma of bone have some characteristics, but also reflect the pathological changes. Combining with the imaging features and clinical characteristics, the diagnosis can be made in most typical cases.