鼻耳部砂粒性骨化性纤维瘤

目的澄清砂粒性骨化性纤维瘤（ｐｓａｍｍｏｍａｔｏｉｄｏｓｉｆｙｉｎｇｆｉｂｒｏｍａ，ＰＯＦ）的组织学特点、生物学特性、临床行为和骨化性纤维瘤、骨纤维结构不良的关系。方法对我院１９５６年６月～１９９６年１２月４０年期间的３１例ＰＯＦ的组织切片，临床和病理记录资料进行回顾性分析。１０例作网织纤维染色、Ｍａｓｏｎ三色染色（ＭＳ）和碱性磷酸酶免疫酶染色（ＡＰ），５例作波纹蛋白，结蛋白，上皮膜抗体和平滑肌肌动蛋白免疫组化染色。１例作了透射电镜。结果１１例完整标本有薄壁骨壳和大小不等的囊腔，触之有砂粒感。组织学上，肿瘤中心区有丰富的肿瘤性间叶细胞和大量的砂粒骨，无骨小梁。肿瘤和正常骨之间有“三带”（肿瘤反应性骨增生正常骨），反应性骨增生带可不明显，肿瘤附近骨组织有被吸收、消失乃致肿瘤进入软组织的现象，但无恶性浸润的性质。１２例复发。无转移。本瘤好发出血和囊性变。结论鼻耳部ＰＯＦ是生长缓慢的良性肿瘤，是不同于骨化纤维瘤和骨纤维结构不良的独立实体，因为有一定的侵蚀性，可复发，治疗为手术切除。

Psammomatoid ossifying fibroma

Objective To clarify the histopathological, clinical behavior biological characterics and the relationship among the psammomatoid ossifying fibroma (POF), ossifying fibroma and fibrous dysplasia of bone. Methods Thirty one cases of POF in the ear and sinonasal region were studied retrospectively. The sections, clinicopathological records from June,1956 to November,1996 were reviewed. The reticulum fiber and Masson's stain and alkaline phosphatase immunostain were done in 10 cases, Vimentin, Desmin, EMA and smooth actin immunohistochemical stain were done in 5 cases. One case was studied by transmission electron microscope. Results The specimens were broken tissue with the sand like felling. eleven specimens with intact thin shell consisted of bone tissue were used to study the changes in the area between tumor and normal bone. Histopathologically they were rich in mesenchymal tumor cells and a lot of calcifying psammomatoid like osteoid and a few of calcified bodies similar to those described by Shafer, and the bony trabecula was not found in the center of the tumor. In addition, three zones were noted at the junction of normal bone and tumor, namely, the normal bone reactive proliferative bone tumor. In some cases , the reactive bony proliferation may be not marked. The normal bone adjacent to the tumor may be absorbed and disappeared, and were then replaced by the tumor, and finally led to tumor tissue invasion into the soft tissue, but the infiltration appearance is not present. Conclusion POF is the slowly growing benign tumor and is different from ossifying fibroma and fibrous dysplasia of bone.