长骨骨化性纤维瘤的诊断（附9例报告）

The diagmosis of long bone osteofibroma:A report of cases/

报告了９例长骨骨化性纤维瘤，男３例，女６例；就诊年龄最小３岁，最大３８岁，平均１７．２２岁；胫骨７例，股骨１例，肱骨１例。临床主要症状表现为局部肿块和疼痛，Ｘ线表现为多囊性溶骨性病变，皮质膨胀变薄，无骨膜反在。本组９例中经临床及Ｘ线正确诊断者仅１例．结合文献报道的病例分析，发现该病虽有一定特征，但临床误诊率甚高，最易误诊为骨纤维异常增殖症。其误诊原因主要因为该病少见，且与骨纤维异常增殖症极相似；也与该病组织结构表现多样呈渐进发展的特性有关。病理检查是确诊的主要手段，有病理骨折者，要尽早活检，取瘤体中心部织，避免骨折修复反应对诊断的影响。复发病例的病理诊断，要以第１次活检材料为准，排除手术后反应对诊断的干扰。与骨纤维异常增殖症难以鉴别时，应多点取材，了解肿瘤全貌，以其主要在现定性。

Nine cases of long bone osteofibroma (LBOF) are reporrted in this paper. This disease is manifested clinically by local lumps and pains and radiologically by polycystic osteolytic lesions,thinned cortex and no periosteal reaction. LBOP is easy to be misdiagnosed as fibrous hyperplasia of bone (FHB) and has a high misdiagnostic rate ,which may be related to its rareness ,similarity to FHB ,variety of pathological morphology ,and gradual progress. The pathological examination should be taken as the main diagnostic means. In pathological fracture, early biopsy should be made,the central part of the tumor should te taken as,the biopsy tissue,avoiding the effec of fracture repair reaction on the diagnosis; in recurrent case,the first biopsy should be taken as the diagnostic basis ,avoiding the intervention of postoperative reaction in the liagnosis;and in difficult differentiation from FHB,multipoint biopsy should be made ,and the main morphological findings taken as the diagnostic basis.