骨旁脂肪瘤临床影像学表现与病理分析

The Manifestation of Clinical Image and Pathalogical Characters of Parosteal Lipoma

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 15例一起列入临床资料分析 ,本病发生于任何年龄 ,成人多见 ,以四肢长管状骨为好发 ,右侧多于左侧 ,其次发生于扁平骨 (骨盆、肩岬骨、肋骨 )、不规则骨 (腰椎、骶尾椎 )、短管状骨和跗骨 ;本文 2 2例术前均行X线摄片 ,7例行CT检查 ,2例行MRI检查。结果 :本病临床误诊率为 4 0 .91% ,X线误诊率 2 7.2 7% ,CT及MRI诊断率 10 0 % ;2 2例均手术切除 ,病理报告为脂肪瘤 ,有 2例低度恶变 ;随访 2年 5例 ,3年 2例 (包括恶变 1例 ) ,4年 2例 ,无一例复发。结论 :骨旁脂肪瘤是最佳的命名 ,病因未明 ,但与遗传、先天因素、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 ;

Objective:The naming,pathogen,clinic and pathological character and image manifestation of the parosteal lipoma were studied in this paper combined with the literature.Methods:Combined with the 15 cases reported in the internal literature, our data demonstrated that this disease happened at any age,more in the adult and the left, then developed more in the long canal bone of the limb,and developed in the flat bone(pelvis,shoulder promontory bone,ribs),anomaly bone(lumbar,ansa sacralis),cauda bone,short canal bone and instep bone secondly;The photographs had been taken for all the 22 cases, CT for the 7 cases,MRI for the 2 cases.Results:This rate of the misdiagnosis was 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 22 cases,and lipoma was diagnosed in pathology,2 casas were malignant slightly;Followed up for 2 to 5 years,none of them was relapsed including 2 cases for 3 years(one of them was malignant)and 2 cases for 4 years.Conclusion:The name of the parosteal lipoma is optimal,the pathogen is not clear,and related to the heredity,hurt and inflammation; Its manifestation is lipoma with bone pedicel in pathology; and is adipose tissuse in cytology;There are characteristic changes in the X-ray,CT and MRI;The extra-integument marginal resection and basal apophysary removal are reliable methods to treat this disease and to provent it from recuring.