长骨中段肿瘤与肿瘤样病变的X线特征性表现

THE DIAGNOSTIC ROENTGENOLOGIC FEATURES OF BONE TUMORS AND TUMOROUS DISEASES OF THE DIAPHYSIS OF LONG BONES

本文报道21例长骨中段的恶性肿瘤、良性肿瘤及肿瘤样病变的X线表现。恶性肿瘤多随长骨纵轴生长且范围较大,软组织肿块的发生率相对较低,骨膜反应虽普遍存在但常不典型,有时还可出现骨膜下骨皮质壳状膨胀及骨嵴或皂泡壳状改变,与良性的不易区别,其它X线表现则与常见的骨恶性肿瘤相似。这种改变可能与肿瘤的种类及长骨中段的特殊解剖组织有关。良性肿瘤因无软组织肿块及骨膜反应,所以变异不大,只是其边缘不及发生在两端者清晰(因长骨中段骨小梁较少)。至于肿瘤样病变则与发生在长骨的两端者相同。

The radiologic manifestations of the diaphyseal malignant bone tumors, benign bone tumors and tumorous diseases of long bone in 21 cases are presented. The growth direction of the malignant bone tumors was always along the vertical axis of the tubular bones. The soft tissue mass formations were less often in diaphyseal malignant tumors of the long bones. Periosteal reactions were generally not characteristic and sometimes there were subperiosteal cortical shell-like expansion, bone ridges or soap bubble changes indistinguishable from the benign ones. The other radiologic malignant appearances were nearly the same as those occurred on the metaphysis. All the characteristics were probably due to the specificities of the histologic anatomical structures of the diaphysis of long bone. The manifestations of the benign diaphyseal lesions were essentially the same as those of the metaphysis except the borders of the former lesions were not so clear due to less bone trabeculae existing in the diaphysis.