肱骨奇异性骨旁骨软骨瘤样增生及相关病变临床、病理、影像特点对比分析

Bizarre parosteal osteochondromatous proliferation and other similar lesions on humerus: a comparative analysis of clinicopathologic and imageologic characteristics

目的探讨肱骨奇异性骨旁骨软骨瘤样增生(bizarre parosteal osteochondromatous proliferation,BPOP)、骨软骨瘤及软骨肉瘤临床、病理、影像特点差异。方法对右肱骨BPOP、右肱骨软骨肉瘤及左肱骨骨软骨瘤各1例进行临床、病理、影像学表现,进行对比分析并随访。结果 BPOP、骨软骨瘤患者无明显疼痛,软骨肉瘤患者伴剧烈疼痛,镜下BPOP由编织骨、钙化性软骨和纤维组织3种成分无规则排列而成,常出现奇异性软骨细胞及特征性"蓝骨",影像学示BPOP病灶位于骨表面,病灶与附着骨之间一般无髓腔相通,可与骨软骨瘤及软骨肉瘤鉴别。结论 BPOP是一种罕见的、良性的骨软骨瘤样病变,与软骨肉瘤、骨软骨瘤易混淆,结合影像学与组织学可以明确诊断。

Purpose To investigate the clinicopathologic and imageologic characteristics of bizarre parosteal osteochon- dromatous proliferation （BPOP）, osteochondroma and chondro- sarcoma. Methods One case of BPOP on right humerus, one case of osteochondroma on left humerus, and one case of chon- drosarcoma on right humerus were analyzed and compared on their clinical, pathologic and imaging manifestations and follow- up. Results The patients of BPOP and osteochondroma did not feel pain, but patient with chondrosarcoma felt severe pain. Mi- croscopically, it was composed of different amounts cartilage, bone, and spindle cells with a poorly organized distribution. It appeared bizarre chondrocyte and characterized ＂blue bone＂.The mass was arising from the surface of the bone and the lesion was not cortical erosion and continuity with medullary cavity in the imaging findings. BPOP, osteochondroma and chondrosarco- ma could be distinguished by the above characteristics. Conclu- sion BPOP is a rare and benign osteoehondroma-like lesion, which may be confused with osteochondroma and ehondrosarco- ma. BPOP can be diagnosed definitely by combining histology with medical imageology.