烧伤62年后双侧胫前多发性皮下骨化性肌炎的临床病理学特征分析

Clinical pathological features of multiple subcutaneous myositis ossificans in a patient 62 years after burn

目的探讨烧伤后皮下多发性骨化性肌炎临床病理特征。方法回顾性分析明确诊断的多发性皮下骨化性肌炎患者的临床资料,观察烧伤后皮下骨化性肌炎的病理形态特点。结果患者为老年女性,于2016年10月13日因胫前肿物表面皮肤破溃在滕州市中心人民医院烧伤整形科就诊。患者于1955年7月3日不慎被火焰烧伤全身多处,创面主要分布于双下肢、双上肢及躯干部,总烧伤面积约40%总体表面积,浅Ⅱ°~深Ⅱ°,双侧胫前创面愈合后残留瘢痕增生。患者成年后发现双侧胫前肿物并溃疡,病理检查可见多形成规则或不规则的环形骨化,镜下见病理组织呈典型带状分布,外围带为成熟组织;中间带为富有细胞的类骨组织,形成不规则互相吻合的小梁。结论骨化性肌炎常发生于外伤后,发生于烧伤后者较为特殊,应引起临床重视;病理学检查是该病确诊的重要依据。

Objective To investigate the clinical pathological features of multiple subcutaneous myositis ossificans.Methods The clinical data of 1 case who diagnosed as multiple subcutaneous myositis ossificans 62 years after burn was analyzed retrospectively,and pathological features of burn concerned subcutaneous myositis ossificans were observed.Results The patient was an old woman,and was admitted to the burn and plastic surgery of Tengzhou Central People′s Hospital for ulceration on the surface of the pretibial neoplasm.The patient was burned On July 3,1955,and wounds were mainly distributed in double lower limbs,two arms and trunk.Total burn area was about 40% of the total surface area,which was from shallow Ⅱ° to deep Ⅱ° degree,and anterior tibial was scarred hyperplasia after wound healing.Histopathological examination showed regular or irregular annular ossificans,the pathological tissue showed typical zonal distribution with mature peripheral tissues under the microscope,the intermediate zone was osteoid tissue rich in cells which formed irregular mutually compatible bone trabecula.Conclusion s Myositis ossificans often occur after injuries and marely occurr after burn which should be paid more attention.Pathological examination is one of the most important bases for the diagnosis of the disease.