骨恶性纤维组织细胞瘤13例临床病理分析

Malignant fibrous histiocytoma of bone:clinicopathologic analysis of 13 cases

目的 观察骨恶性纤维组织细胞瘤 (BMFH)病理形态 ,进一步探讨其组织形态学发生、病理学诊断及鉴别诊断。方法 通过形态学观察、免疫组织化学应用并结合有关电镜文献资料及相关临床病理资料进行综合分析。结果 BMFH由骨原始间充质细胞发生并具有组织细胞、原纤维细胞形态学特征和免疫学表型及中间型细胞 (过渡细胞 )超微结构特点和多项分化潜能。结论 BMFH从形态学上须与骨纤维肉瘤、恶性骨巨细胞瘤及特殊类型骨肉瘤相鉴别 ,从组织学发生上彼此间也有着密切的联系 。

Purpose To investigate the histogenesis, clinicopathological feature and differential diagnosis of bone malignant fibrous histiocytoma (BMFH) by microscopic observation. Methods Morphology, immunohistochemistry, literature related to electron microscopy study combined with the clinicopathological data were analyzed in 13 cases of BMFH. Results BMFH originated from mesenchymal cell of bone, expressing histocytic and fibroblastic marker, and possessing ultrastructural features of intermedia cells and polynomial differentiated potential. Conclusions BMFH differs from osteofibrosarcoma, malignant giant cell tumour of bone, and special types of osteosarcoma in morphology,though there is a close correlation in histogenesis among them. Fine needle biopsy can provide reliable information for clinical diagnosis and management before operation.