骨嗜酸性肉芽肿(附10例报告和文献复习)

Eosinophilic granuloma of bone:a report of 10 cases and review of the literature

目的研究骨嗜酸性肉芽肿(EGB)的X线特征与临床表现。方法回顾性分析了10例经病理证实为EGB(女7例,男3例,年龄3岁～22岁,平均年龄13.5岁)的X线征象与临床表现。结果EGB发病部位有颅骨2例,腰椎2例,髌骨、肋骨、肱骨、胫骨及趾骨各1例,多发(累及颅骨及双侧股骨)1例。X线表现:长骨病变多发生于骨干,多为单发病灶,呈溶骨性破坏,境界清楚。扁骨病变呈不规则溶骨性破坏,边界清楚。腰椎病变表现为椎体变扁,密度增高。主要临床表现为发热,白细胞增多,局部疼痛、触痛,或伴肿胀。病变多发者症状重,易复发,预后差。结论EGB的X线表现虽有一些特征,但确诊需结合临床表现或依靠活检。

Objective To investigate X-ray features and clinical manifestations of eosinophilic granuloma of bone (EGB).Methods X-ray features and clinical manifestations of 10 patients(femal 7, mal 3, aged 3～22 years old,mean age:13.5 years old)with pathologically proved EGB were analyzed retrospectively.Results The locations of EGB in all cases were skull in 2,lumbar vertebrae in 2,kneecap in 1,costal bone in 1,humerus in 1,tibia in 1,phalanx in 1,and multiple EGB involved to skull and bilateral femura in 1.The lesions of EGB found in long bone were mostly unifocal,mostly located in diaphysis and were characterised by lytic destruction with well-definite margin.The lesions of EGB found in flat bone presented irregular lytic destruction with clear border.The lesions of EGB in lumbar vertebrae presented as flatenning verteblar bodies and increasing density.Main presentations of EGB were fever and leukocytosis,local pain,tenderness,and swelling.In patients with multiple lesion,severer symptoms,recurrence and ill prognosis could be observed.Conclusion Although EGB has some X-ray features,yet the definite diagnosis needs combine with clinical manifestations or use fine-needle aspiration biopsy.