| 高振华,尹军强,孟悛非.原发性骨平滑肌肉瘤的临床、影像学和病理分析及文献复习[J].中国医学影像技术,2012,28(7):1383~1386 |
| 原发性骨平滑肌肉瘤的临床、影像学和病理分析及文献复习 |
| Clinical, imaging and pathological analysis of primaryleiomyosarcoma of bone and literature review |
| 投稿时间：2011-11-04 修订日期：2011-11-16 |
| DOI： |
| 中文关键词: 平滑肌肉瘤 骨和骨骼 体层摄影术,X线计算机 磁共振成像 病理学 |
| 英文关键词:Leiomyosarcoma Bone and bones Tomography, X-ray computed Magnetic resonance imaging Pathology |
| 基金项目: |
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| 摘要点击次数: 2845 |
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| 中文摘要: |
| 目的 分析原发性骨平滑肌肉瘤(PLB)的临床、影像学和病理学表现。方法 回顾性分析6例PLB的临床资料,结合1980-2010年相关国内文献,观察其临床、影像学表现和病理学特点。结果 6例PLB中,病变位于胫骨上段2例,股骨下段1例,股骨干1例,肱骨远端1例,骶骨1例,均未见骨膜新生骨;4例表现为边界不清的溶骨性骨质破坏,2例表现为边界较清的囊状骨质破坏;3例MR T1WI呈等信号,T2WI稍高信号,增强扫描有明显强化;免疫组化Vim、Actin和SMA均阳性,S-100阴性。复习文献中的53例PLB,单骨受累50例,多骨受累3例;39例有X线片资料,37例可见边界不清的溶骨性骨质破坏,2例见边界较清的囊状骨质破坏,其中2例可见病理性骨折伴骨膜新生骨。结论 PLB罕见,多表现为单骨溶骨性骨质破坏,无骨膜新生骨,但其临床和影像学表现并不典型,术前诊断需要依赖免疫组化。 |
| 英文摘要: |
| Objective To investigate the clinical, imaging and pathological features of primary leiomyosarcoma of bone (PLB). Methods Totally 6 patients with PLB were collected. The clinical manifestations, imaging findings and pathologic appearances in 6 cases with PLB were retrospectively analyzed and the domestic related literatures from 1980 to 2010 were reviewed. Results Of 6 patients, the tumor located in upper tibia (2 cases), lower femur (1 case), femoral shaft (1 case), distal humerus (1 case) and sacrum (1 case). There was no periosteal new bone formation in all 6 cases. Ill-defined osteolytic destruction was detected in 4 patients, while well-defined cystic destruction was found in the other 2 patients. The tumors showed iso-intensity signal on T1WI, hyper-intensity signal on T2WI and obvious enhancement after injection of Gd-DTPA. Immunohistochemically, all tumors reacted positively with Vim, Actin and SMA, but the S-100 were negative. Reviewing domestic literatures, 53 cases of PLB were analyzed, 50 involved single bone and 3 involved multiple bones. X-ray description of PLB was seen in 39 cases, including ill-defined osteolytic destruction in 37 cases and well-defined cystic destruction in 2 cases. Except for 2 cases with periosteal new bone formation after pathological fractures, there was no periosteal new bone formation in other 37 cases. Conclusion PLB is rare, most showing osteolytic destruction in single bone without periosteal new bone formation. However, clinical and imaging manifestations of PLB are not specific. The definite diagnosis of PLB needs immunohistochemical examination. |
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