骨原发性黄色瘤5例临床病理分析

Primary xanthoma of bone: a clinicopathological study of five cases

目的进一步探讨骨原发性黄色瘤的性质、病理学特点及其鉴别诊断要点。方法观察5例骨原发性黄色瘤的临床病理特点,结合组化和免疫组化及随访资料进行综合分析。结果5例患者均为成人,肿瘤单发,分别位于枕骨、胫骨和股骨两端。X线示骨有膨胀性、溶骨性、破坏性病变。组织学以纤维组织细胞增生伴大量黄色瘤细胞聚集及多少不等的慢性炎症细胞为特点;组化及免疫组化显示黄色瘤细胞的组织细胞特点。结论骨原发性黄色瘤可能为一种骨的局灶性反应性脂质吸收性病变,主要应与含黄色瘤成分的其他良性骨病以及骨的转移性透明细胞癌鉴别。

Objective To analyze the pathological features of xanthoma of bone and its differential diagnosis. Methods The clinicopathological features of bone xanthoma were studied, and the histochemical and immunohistochemical findings and follow - up results were analyzed in 5 cases. Results All the five patients were adult. The lesions were single and located at the end of femurs, tibia or skull. X-ray showed expansive osteolytic lesions. Histopathologic study revealed a collection of foam cells and giant cells with fibrosis and chronic intlammatory cells. The histochemical and immunohistochemical studies showed foam cells had the features of histiocytes. Conclusion It is possible that the primary xanthoma of bone is a reactive absorbed lesion to lipoid. The differential diagnosis includes metastatic clear cell carcinoma and other benign lesions that contain foam cells and giant cells.