骨膜骨肉瘤3例临床病理观察

目的探讨骨膜骨肉瘤的临床病理特点及鉴别诊断。方法对3例骨膜骨肉瘤进行常规病理及影像学分析。结果3例均表现为局部肿块伴疼痛;影像学显示骨皮质表面软组织阴影,其中1例伴局灶性髓腔浸润。镜下均可见以软骨母细胞为主的瘤细胞呈分叶状排列,小叶周边梭形细胞排列密集,异型性明显,细胞间可见少量骨样基质形成;1例可见肿瘤侵犯骨皮质及周围软组织,并且局部髓腔内见瘤组织浸润。结论骨膜骨肉瘤是一种发生于骨表面的罕见骨肉瘤,伴发髓腔浸润者更为少见。综合临床病理特点及影像学特征有助于此病的诊断及鉴别诊断,早期诊断并及时治疗可以改善患者的预后。

Periosteal osteosarcoma:a clinicopathological analysis of 3 cases

Objective To investigate the clinicopathologic features and differential diagnosis of the periosteal osteosarcoma. Methods Three causes of periosteal osteosarcoma was analyzed by light microscopy and radiography. Results Three patients presented a growing painful mass. The histological appearance of the tumor was predominantly moderately differentiated chondroblastic osteosarcoma, with small islands of anaplasic spindle cells that produced malignant osteoid. Additionally, in one case we observed that femoral cortex and soft tissue were invaded, and the medullary cavity was involved. Radiographically, it showed that spiculated calcifications oriented perpendicularly to the cortical surface and extended into a soft tissue mass. Conclusion Periosteal osteosarcoma is a rare intermediated-grade surface osteosarcoma, and secondary bone marrow involvement is unusual, which differs other osteosarcomas from striking histologic and radiographic features. Early diagnosis and appropriate treatment can improve patients prognosis.