Mohr Winfried
Department of Pathology, University of Ulm, Germany.
Pathol Res Pract. 2002;198(9):585-8. doi: 10.1078/0344-0338-00306.
In a case of synovial osteo-chondromatosis of the knee joint, foci of hyaline and calcified cartilage in the synovial membrane exhibited neither MIB-1-positive cells nor mitotic figures. Loose bodies of the synovial fluid showed a different proliferation behavior. In addition to cartilaginous nodules without MIB-1-positive cells, some of the bodies contained nearly 17% cells with MIB-1 activity. Besides the huge number of cells expressing the proliferation-associated antigen, no mitoses, except for a rare, possibly pycnotic mitosis, could be detected. It is assumed that owing to delayed fixation of the chondrocytes surrounded by a broad hyaline cartilaginous matrix, mitoses of these cells can be completed even in the absence of physiological nutrition. The observation described may explain the occurrence of multiple loose bodies in osteo-chondromatosis. According to Milgram's theory, pedunculated nodules of the synovial membrane can become detached, and thereafter appear in the synovial fluid. In this nourishing environment, they can grow to a certain degree; larger ones perhaps become fragmented because of the force of movement, resulting in smaller particles that grow again. This indicates a vicious circle that leads to a myriad of loose bodies.
在一例膝关节滑膜骨软骨瘤病中，滑膜内透明软骨和钙化软骨灶未见MIB-1阳性细胞及有丝分裂象。滑液中的游离体表现出不同的增殖行为。除了无MIB-1阳性细胞的软骨结节外，部分游离体含有近17%具有MIB-1活性的细胞。除了大量表达增殖相关抗原的细胞外，除了罕见的、可能为固缩性有丝分裂外，未检测到有丝分裂。推测由于被宽阔透明软骨基质包绕的软骨细胞固定延迟，这些细胞即使在缺乏生理营养的情况下也能完成有丝分裂。所描述的观察结果可能解释了骨软骨瘤病中多个游离体的发生。根据米尔格拉姆理论，滑膜的带蒂结节可脱落，随后出现在滑液中。在这种滋养环境中，它们可生长到一定程度；较大的游离体可能因运动力而破碎，形成较小的颗粒，这些颗粒又会再次生长。这表明存在一个恶性循环，导致大量游离体产生。
