囊性纤维性骨炎——附2例临床病理分析

Osteitis fibrosa cystica:a clinicopathologic study of 2 cases

目的 探讨囊性纤维性骨炎的临床病理特征、诊断及鉴别诊断要点。方法 对2例囊性纤维性骨炎标本进行病理组织学观察。结果 组织学特征为:富细胞的纤维组织及多核巨细胞和富含含铁血黄素的吞噬细胞聚集在一起形成结节,其中伴有较多的新鲜和陈旧性出血及新生血管。在增生的纤维组织中有较多的胶原纤维,多核巨细胞较小,分布不均,有的聚集成堆。在病灶周围见有新骨形成。成排的骨母细胞及较多的破骨细胞骨吸收现象。大小不等的囊腔形成,囊壁为纤维组织。结论 囊性纤维性骨炎是由于甲状旁腺肿瘤或增生所引起的内分泌障碍性骨的瘤样病变。在临床上多因缺乏特殊症状而被误诊。常由病理检查诊断后再提示临床进行相应的检查和治疗。

Objective To study the clinical pathological characteristics and diagnostic criteria of osteitis fibrosa cystica (OFC)and its differential diagnosis from other bone tumors. Methods 2 cases of OFC were studied by histopathological observation . Results The histological findings of OFC are characterized by nodular aggregations formed by multinuclear giant cell with rich fibrous tissue, and phagocyte rich with hemosiderin, accompanied by fresh and old hemorrhage and newly grown blood vessels. Large amounts of collagen fibers were found in the proliferated fibrous tissue. The multineuclear cells were small in size and, distribute unevenly with some aggregate in piles. New bone formation was seen around the lesion, osteoclast absorption and osteoblast ingrown around the bone trabecula were also found; Many cystic cavities of different sizes developed with the wall formed by fibrous tissue. Conclusions Osteitis fibrosa cystica is a tumor - like lesion of bone, because of the endocrine disorder caused by par-athythroid tumor or hyperplasia; due to the absence of special symptoms, the condition is often misdiagnosed clinically. Oft - times the pathologic diagnosis of the condition reminds the clinicians to start the corresponding examinations and treatment.