骨旁脂肪瘤临床影像学表现与病理分析(文献综述附14例报告)

目的]结合文献探讨骨旁脂肪瘤的命名、病因、临床病理表现和影像学特点。方法]将国内文献的20例一起列入临床资料分析,包括作者14例共34例术前均行X线摄片,18例行CT检查,4例行MRI检查。结果]本病发生于任何年龄,成人多见,以四肢长管状骨为好发,其次发生于扁平骨(骨盆、肩岬骨、髌骨、肋骨)、不规则骨(胸椎、腰椎、骶尾椎)、短管状骨和跗骨;本病临床误诊率为41.17%,X线误诊率26.47%,CT及MRI诊断率100%;34例均手术切除,病理报告为脂肪瘤,3例低度恶变;随访2~10年,仅1例复发并恶变。结论]骨旁脂肪瘤是最佳的命名,病因未明,但与遗传和先天因素及创伤和炎症因素有关;病理表现为带骨蒂的脂肪瘤,细胞学形态为脂肪组织;影像学具有特征性表现。

Manifestation of clinical image and pathalogical characters of parosteal lipoma ( literature review with a report of 14 cases)

Objective]The naming,pathogeny,clinic,patho logical character and image manifestation of the parosteal lipoma were discussed in this paper combined with the literatures.Method]Combined the 20 cases reported in the internal literatures,the photographs have been taken in all the 34 cases,CT in the 18 cases,MRI in the 4 cases.Result]The data demonstrated that this disease betided in any age,more in the adult,developed more in the long canal bone of the limb,and developed in the flat bone(pelvis,scapula,costal bone,patella),anomaly bone(thoracic verthbrae,lumbar,ansa sacralis),cauda bone,short canal bone and instep bone secondly.The rate of the error diagnosis were 40.91% in the clinic,27.27% in the X-ray and no one in the CT and MRI.The excision was done in all the 34 cases,and lipoma were diagnosed in pathology,3 cases were malignant slightly.Followed up for 2 to 10 years,only 1 cases recurring and malignant.Conclusion]The name of the parosteal lipoma is optimal,the pathogeny is not clear,and related to the heredity,hurt and inflamation.There is lipoma with bone pedicel in pathology;and adipose tissuse in cytology.There are characteristic changes in the X-ray,CT and MRI.