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目的探讨髓内高分化骨肉瘤的临床、病理、放射学(X线、CT、MRI)特点及鉴别诊断。方法通过对1例髓内高分化骨肉瘤的分析,结合该肿瘤有关的文献回顾,归纳总结髓内高分化骨肉瘤的临床、放射和病理学诊断要点。结果发病年龄30～40岁多见,病损范围较大。肿瘤多位于长骨干骺端,特别是股骨下端和胫骨上端,表现为骨髓腔内破坏和修复同时存在的肿物。肿瘤由纤维及骨组织构成,细胞分化良好,核分裂相少见。50%的患者于初诊时误诊为良性病变。结论该病早期诊断较困难,了解其病理、免疫组化特点,结合临床将有助于做出正确的诊断。
Objective To investigate the clinical features, pathology and radiology (X-ray, CT, MRI) features and differential diagnosis of intramedullary well-differentiated osteosarcoma. Methods Based on the analysis of 1 case of intramedullary well-differentiated osteosarcoma and the literature review of this tumor, the clinical, radiological and pathological diagnosis of intramedullary well-differentiated osteosarcoma were summarized. The results of age 30 to 40 years old more common, a larger range of lesions. Tumors are located in the long bone metaphysis, especially the lower femur and tibia, the performance of the bone marrow cavity destruction and repair of concurrent mass. The tumor is composed of fibers and bone tissue, cells well differentiated, mitotic phase rare. Fifty percent of patients are misdiagnosed as benign lesions at the time of first visit. Conclusion Early diagnosis of the disease is more difficult to understand the pathological features of immunohistochemistry, combined with clinical will help to make the correct diagnosis.