骨膜骨肉瘤的影像学诊断与病理学分析

Imaging diagnosis and pathological analysis of periosteal osteosarcoma

目的:探讨骨膜骨肉瘤的影像学及组织病理学特点。方法:收集6例骨膜骨肉瘤患者的临床及影像资料;6例均摄X线平片,5例行CT扫描,4例行MRI扫描;对其影像学及组织病理学表现进行分析和总结。结果:骨膜骨肉瘤好发于胫骨,影像学表现为发生在长骨的骨干或相当于干骺部位置的骨表面肿块,病灶内见局灶性骨化或环状钙化(本组3例),边缘可见骨膜反应(本组2例),肿瘤下骨皮质不受侵,但不侵犯骨髓腔。骨膜骨肉瘤组织学上由大量分叶软骨构成,肿瘤细胞呈明显异型性。结论:骨膜骨肉瘤是位于长骨骨皮质表面的恶性骨肿瘤,影像表现与病理表现相结合可作出正确诊断。

Objective：To investigate the radiological and histopathological features of periosteal osteosarcoma.Methods：Among 6 cases with periosteal osteosarcoma,all patients underwent X-ray,5 cases CT scan,and 4 cases MRI scan.Imaging and histological findings were analyzed.Results：Periosteal osteosarcoma was frequently found on tibia.On imaging,periosteal osteosarcoma appeared as a partially mineralized mass on the cortical surface of a long bone in the portion of the diaphysis or metaphysis,focal ossification or annular calcification were seen inside the lesions（3 cases in this group） ;by the margin of tumor,periosteal reaction was revealed （2 cases in this group） ;and no erosion of the underlying cortex was observed,while the medullary cavity remained intact.The histological appearance of the tumor was predominantly one of low or medium-grade malignant chondrosarcoma,the tumor cells displayed obvious atypia.Conclusion：Periosteal osteosarcoma arises from the surfaces of long bones,combination of imaging and pathological examinations is important for diagnosis of the periosteal osteosarcoma.