摘要
目的探讨棕色瘤的临床、病理特征和影像学表现，提高对该病的认识和诊断水平。方法回顾性分析2012年1月-2015年6月中山大学附属第五医院15例经病理证实棕色瘤的临床、病理和影像学资料，总结该病影像学表现及病理基础，并对原发性和继发甲旁亢所致棕色瘤的各自特点及鉴别要点进行分析。结果15例棕色瘤中，年龄26～66岁，其中原发甲旁亢者7例，继发者8例（均为尿毒症血透患者）；15例共34处病灶，其中弥漫骨质疏松13例、骨质硬化2处，单骨受累4例，多骨受累11例；膨胀性改变26处、溶骨性骨质破坏6处；周围骨皮质增厚12处；病灶内部骨化钙化者23处；伴有软组织肿块13处，其中明显强化者3处。病理表现以纤维组织为主，富含血管，其内有散在含铁血黄素沉积，周围有骨样组织。结论棕色瘤具有相对特异性的临床和实验室特点，影像学诊断不难，其目的在于指导临床缩小鉴别诊断范围及早期诊断。影像学上病灶内骨化或钙化，可伴有软组织肿块并明显强化，边缘增生硬化具有一定特点；继发甲旁亢常见多骨受累，可伴全身弥漫骨质硬化，且较多累及中轴骨。
Objective To explore the clinical, pathological characteristics and imaging manifestations of brown tumors caused by hyperparathyroidism, to improve the cognition of the disease. Methods The clinical, pathological characteristics and imaging manifestations of 15 cases of pathologically confirmed brown tumors were retrospectively reviewed. To analyze the imaging and pathological correlations, in addition, between the primary and secondary hyperparathyroidism led to brown tumors differential diagnoses. Rseults In the 15 cases, aged from 26 to 66 years with median age of 51 years, 7 cases were caused by primary hyperparathyroidism, 8 cases secondary to long-term hemodialysis. Of the 15 cases （total of 34 lesions） , 11 cases were multi-part bone involved. 13 of 15 patients for osteoporosis and 2 cases were osteosclerosis. 32 lesions had bone destruction, 26 lesions showed expansive bone destruction,6 showed soluble bone destruction, 12 lesions had harden edge. 23 lesions in bone destruction had calcification or ossification internal. 13 cases with soft tissue mass, enhanced significantly can be found in 3 cases. 2 lesions occured in the skull, bone density increased and the plate edge blur. pathological findings fibrous tissue , rich in blood vessels, scattered hemosiderin deposition, osteoid tissue around it. Conclusion Brown tumor has relatively specific clinical history and laboratory characteristics. The imaging features include harden edge, in bone destruction has calcification or ossification internal and with soft tissue mass some enhanced significantly. The secondary brown tumor more multi-part destruction and more vertebra were involved than the primary. We can find osteosclerosis in secondary brown tumor. Those characteristic features were important to help for the diagnosis of the brown tumor.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2015年第45期3691-3694,共4页
National Medical Journal of China
