骨良性纤维组织细胞瘤的影像学表现及临床病理分析

Radiological and clinicopathological analysis of benign fibrous histiocytoma of bone

目的:探讨骨良性纤维组织细胞瘤(BFH)的影像学特征及临床病理特点,以提高对该病的认识及诊断水平。方法:回顾性分析经手术病理证实的16例骨BFH患者临床及影像学资料,并结合相关文献进行综合分析。结果:16例中行X线检查14例,呈囊状膨胀性骨质破坏,10例见残存骨嵴,9例有增生硬化边,均未见软组织肿块;行CT检查2例,呈膨胀性骨质破坏,其内为软组织密度,增强1例,有强化;行MRI检查9例,5例呈长T1长T2信号。1例囊性部分等T1长T2信号,实性部分等T1等T2信号。1例病理性骨折周围软组织受侵,呈等T1长T2信号。2例位于颈椎棘突,分别为长T1短T2及等T1等T2信号。6例病灶内T1、T2均见条索状低信号。4例见长T1短T2硬化边。均行Gd-DTPA增强扫描,实质及条索状分隔有强化。结论:骨BFH影像表现具有一定特征性,综合X线、CT及MRI检查有助于提高对该病的术前诊断。

Objective To explore the imaging radiological and clinicopathological characteristics of benign fibrous histiocytoma （BFH） of bone, in order to improve the imaging diagnostic accuracy of the disease Methods Radiological and clinical data of 16 patients with BFH confirmedbypathology were retrospectively analyzed, and relevant literatures were reviewed. Results The X-ray findings of 14 BFHpatients were osteolytie lesion, expansive destruction of bone,without soft tissue involvement, 10 with residual apophysis, 9 with osteosclerosis marginal; CT was performed on 2 patients. Expansive destruction of bone and soft tissue densities were seen inside the loops, 1 case remarkable enhancement of the lesion. MRI was performed on 9 patients and 5 cases showed long T1 and T2 signal intensity; lcase showed equal T1 and long T2 signal intensity in cystic part and equal T1 and T2 signal intensity in the solid part. One patient had pathological fracture, and the surrounding soft tissue invaded, showing equal T1 and long T2 signal intensity. Two lesions located at spinous process of cervical vertebra, showing long T1 short T2 and equal T1 and T2 signal intensity. Linear low signal separation shadow in T1 and T2 could be seen in 6 cases. Long T1 and short T2 sclerotic ring were seen in 4 cases. Solid part of tumor and linear separator were obviously enhanced. Conclusions The radiological findings of benign fibrous histioeytoma of bone indicate some characteristics. The combination with X-ray, CT and MRI examination is helpful to improve the diagnostic accuracy of the disease before operation.