骨原发恶性纤维组织细胞瘤的病理特点及X线征像(附16例报告)

背景与目的:恶性纤维组织细胞瘤(Malignantfibroushistiocytoma,MFH)是软组织常见的恶性肿瘤之一,原发于骨者比较少见,其组织来源仍存在争议。本研究旨在探讨原发性骨恶性纤维组织细胞瘤的病理特点、X线特征,以提高对本病影像诊断水平。方法:回顾分析我院1982年1月至2002年6月收治的经病理检查证实的16例原发性骨恶性纤维组织瘤的临床、病理及X线资料。结果:病理表现有多核瘤巨细胞的存在,瘤细胞的多样性,成纤维细胞呈车轮状排列。病理组织由多种细胞成分构成,但以成纤维细胞和组织细胞为主。X线表现以单发性溶骨性破坏为主,肿瘤周围的骨皮质有不同程度膨胀,病灶突破骨皮质形成软组织肿块,骨膜反应或病理性骨折。结论:MFH在病理上和X线影像表现上均呈多样性,无明显特征,但结合临床表现、X线像表现和病理检查能作出诊断。

Pathologic and X-ray features of primary malignant fibrous histiocytoma of bone--a report of 16 cases

BACKGROUND & OBJECTIVE: Malignant fibrous histiocytoma (MFH) is a common soft tissue tumor, which rarely occur in the skeleton. Its histological origin still remains controversial. This study was to investigate the pathologic and X-ray features of primary MFH of bone, and provide reference for imaging diagnosis. METHODS: Clinical data and X-ray images of 16 MFH patients, treated from Jan. 1982 to Jun. 2002 in the First Affiliated Hospital of Soochow University, were analyzed retrospectively. RESULTS: Pathologic manifestations of the patients were malignant multinucleated giant cells, pleomorphic and bizarre form of the tumor cells, and wheel-spoke arrangement of the fibroblast-like cells. Pathologically, the tumor tissue was consisted of various kinds of cells, which were mainly fibroblasts and histiocytes. The principal X-ray manifestations included solitary osteolytic changes, cortical expansion around the tumor, the penetration of the cortex with soft tissue mass formation, slight periosteal reaction and pathologic fracture. CONCLUSION: The diagnosis of MFH mainly depends on pathologic examination and X-ray manifestations.