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纤维骨瘤

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Pathological diagnosis as follows: Chon- droblastoma (3 cases), giant cell tumor of bone (3 eases), fibrous dysplasia (2 cases), non-ossifying fibroma (1 case), and esosinophilic granuloma of bone (1 case).

材料和方法:经手术病理和临床活检证实共10例,其中成软骨细胞瘤和骨巨细胞瘤各3例,骨纤维异常增殖症2例,非骨化性纤维瘤和嗜酸性肉芽肿各1例。

CT is the modality of fist choice in diagnosis of ossifying fibroma of craniofacial region, especially, CT bone algorithm reconstruction is valuable to its final diagnosis, MRI, as a complemental imaging examination method, also has some characteristics, the combined application of both contributes to the improvemet of its diagnostic accuracy.

CT是颅面部骨化性纤维瘤的首选检查方法、尤其是CT骨窗对该病诊断价值较大,MRI表现也具有一定的特征,是一项重要的辅助检查手段,二者的联合应用可提高该肿瘤诊断的准确性。

Methods : From July 2003 to November 2007, 21 cases of sarcoma and SC Cancerous ulcer patients were treated, among which 11 cases male and 10 cases female, the age 14~83 (average 50 years old) and upper limb 6 cases and lower limb 15 cases; The pathologic diagnosis is: SC 6 cases, synovial sarcoma 4 cases, malignant fibrohistiocytoma 3 cases, adipose sarcoma 2 cases, osteogenic sarcoma 2 cases, malignant melanoma 2 cases, sarcoma epithelioides 1 case, derma-eminence fibrosarcoma 1 case.

自2003年7月~2007年11月治疗21例肉瘤及鳞癌性溃疡患者,男性11例,女性10例,年龄14~83(平均50岁)。上肢6例,下肢15例;病理为:鳞癌6例,滑膜肉瘤4例,恶性纤维组织细胞瘤3例,脂肪肉瘤2例,骨肉瘤2例,恶性黑色素瘤2例,上皮样肉瘤1例,皮肤隆突性纤维肉瘤1例。

[Objective]To approach the clinical characteristic,diagnosis and method of treatment of malignant fibrous histiocytoma of bone.

[目的]探讨骨的恶性纤维组织细胞瘤的临床特点、诊断及治疗方法。

RESULTS The CT feathures of ossifying fibroma inparanasal sinus were similar to rotundity or unregular single high density lump in sinus, part area of low was expansive growth.

鼻窦内圆形或圆形高密度影,密度均匀或不均匀,部分区域内见低密度影,表面为厚薄不均的骨壳,界限清楚,为骨化纤维瘤的CT表现特点。

Results Microscopically, the tumor cells were epithelioid or short spindled and special nests of tumor cells separated by arboring fibrovascular septa. Such morphological variants of CCSK as myxoid degeneration, microcysts formation and sclerosing pattern of extracellular hyalined collagen simulating osteoid were present in some regions.

结果 镜下见瘤细胞为上皮样或短梭形,被分枝状纤维血管间质分隔成巢团状,部分区域见黏液样变性微囊肿和细胞外胶原玻璃样变类似骨样组织的硬化型等形态变异。

Results]All ossifying fibroma have the feature of benign bone tumor, intracortical osteolysis clearly marginated by a band of sclerosis, inhomogeneous calcification and ossification in the lesion, no periosteal reaction and soft tissue mass. Predominant involvement of the tibia.

结果]长骨骨化性纤维瘤具有一般良性骨肿瘤的特征,表现为骨干骨皮质内的溶骨性破坏区,边缘多有硬化缘,其内可见钙化或骨化影,周边无软组织肿块和骨膜反应,特别是发生于胫骨前端骨皮质的具有上述表现的病灶。

Conclusion]Ossifying fibroma have the feature of benign bone tumor especially lesion locating anterior cortex of tibia.

结论]长骨骨化性纤维瘤具有一般良性骨肿瘤的特征,位于胫骨骨干前端骨皮质内病变最具特征性。

Objective:To explore the clinical and pathological dignosis of fibrous dysplasia of bone and ossifying fibroma for improving the dignsis accuracy.

骨纤维结构不良、骨化性纤维瘤两种病的发病部位和组织结构均有相似之处,前者属骨发育异常瘤样病变 [1] 。

Results:The positive expression of P53 and c-Myc protein in nuclei was bound up with poor-differentiated tumours;the positive expression of Fas and c-Myc protein in cytoplasms was consistent with well-differentiated tumours.

采用免疫组织化学方法对骨肉瘤、骨化性纤维瘤、骨纤维结构不良和正常骨痂组织进行c-Myc、Fas和P53蛋白测定,与肿瘤组织学分级、细胞分化及核丝分裂比较分析。

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从鲍尔点的形成原理出发,分析对称连杆曲线上鲍尔点的产生条件,提出等边机构的对称连杆曲线上有单鲍尔点和双鲍尔点。

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