长骨良性纤维组织细胞瘤影像学征象分析(附18例)

Imaging characteristics of benign fibrous histiocytoma of the long bone: 18 cases

目的:探讨长骨良性纤维组织细胞瘤的临床及影像学表现,以提高对该疾病的诊断水平。方法:结合手术病理诊断,回顾性分析18例长骨良性纤维组织细胞瘤的临床表现和影像特点。结果:18例行X线检查,14例行CT检查,10例行MRI检查。发生在骨干12例,干骺端4例,骨端2例。所有病例均见不连续的硬化缘,病灶内见不规则致密分隔。位于骨干表现为纵向膨胀性中心性骨质破坏,位于干骺端及骨端表现为横向膨胀性偏心性骨质破坏。9例出现病理性骨折。1例发生在胫骨近端病灶见骨膜反应。所有病例均未发现软组织肿块。结论:长骨良性纤维组织细胞瘤好发于中青年,股骨、胫骨骨干多见,膨胀性溶骨性骨质破坏,周围可见不规则断续硬化缘,内部可见骨性分隔,无骨膜反应及软组织肿块,可出现病理性骨折,磁共振T2WI为高低混杂信号,熟悉这些征象有助于该病的诊断。

Objective:To explore the clinical and imaging features of benign fibrous histiocytoma(BFH)of the long bone in order to improve the diagnosis of BFH.Methods:By the pathological diagnosis,we analyzed clinical and imaging characteristics of 18 BFH cases,retrospectively.Results:All cases underwent radiography.14 cases underwent CT,and 10 cases underwent MRI.12 cases localized in diaphysis,and 4 cases localized in metaphysic,and 2 cases localized in epiphysis.There were discontinuous sclerotic rim and irregular separations in all cases.BFH in the diaphysis was longitudinal center expansion bone destruction,in the metaphysis and epiphysis showed transverse eccentric expansion damage.9 cases had pathological fracture.1 case in the proximal tibia metaphysis had periosteal proliferation.All cases didn't have soft tissue mass.Conclusion:Benign fibrous histiocytoma of the long bone occured in the young and middle-aged people.The diaphysis of femur and tibial was common.It was dilated osteolytic bone destruction with irregular intermittent sclerotic edge around,and bone septum could be seen inside.No periosteum reaction and soft tissue mass.Pathological fracture could be seen.Magnetic resonance imaging on T2WI was high and low mixed signal.Familiar these signs were conductive to the diagnosis of this disease.