非骺性骨巨细胞瘤

Radiographic Features of Non-epiphyseal Giant Cell Tumors of Bone

目的 总结非骺性骨巨细胞瘤的X线表现能否反映肿瘤组织的病理分级。资料与方法 回顾性分析经病理证实的非骺性骨巨细胞瘤 7例 ,男 6例 ,女 1例。平均年龄 2 3.3岁。结果 良性非骺性骨巨细胞瘤 (1～ 2级 )X线表现为膨胀性溶骨性破坏 ,肿瘤不侵犯到骨壳外。侵袭性者 (2级 )X线表现仍为溶骨性破坏 ,但肿瘤可突破到骨壳外 ,或形成双骨壳 ,并可突破骺板侵入骨骺。恶性者 (3级 )表现为严重的溶骨性破坏 ,无膨胀性 ,无骨壳 ,或出现多层隐约的骨壳。其中 1例有棉絮样骨化。骨巨细胞瘤边缘筛孔征具有参考性的定性价值。

Objective To analyze radiographic manifestations of non epiphyseal giant cell tumors of bone, and to find out whether radiological signs can reflect the pathologic grade of the lesion.Materials and Methods Radiographic findings in 7 patients (6 males and one female, mean age 23.3 years) with pathologically proved non epiphyseal giant cell tumors of bone were retrospectively analyzed.Results Grade Ⅰ lesion showed typical radiological signs, being characterized by expansive, osteolytic bony destruction without rupture of the bony shell. Grade Ⅱ lesion was manifested as osteolytic bony destruction, with tumor breaking through the bony shell and, in consequence, forming double shelled appearance. The tumor could also invade the epiphysis. Grade Ⅲ tumor, as malignant lesion, was marked by severe, non expansive osteolytic bony destruction with no bony shell or carrying a multi layered bony shell. Cloudy ossification was seen in one lesion.Conclusion The radiographic signs of non epiphyseal giant cell tumors of bone are valuable for reference to predict the pathologic grade of the disease.