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恶性软骨源性骨肿瘤的病理形态学——对汉堡骨肿瘤登记处94例病例的分析(1974 - 1989年)

[Pathomorphology of malignant chondrogenic bone tumors--an analysis of 94 cases from the Hamburg Bone Tumor Register (1974-1989)].

作者信息

Delling G, Welkerling H

机构信息

Abt. Osteopathologie, Universität Hamburg.

出版信息

Z Orthop Ihre Grenzgeb. 1992 Jan-Feb;130(1):1-8. doi: 10.1055/s-2008-1039505.

DOI:10.1055/s-2008-1039505
PMID:1532267
Abstract

89 central and 5 periosteal chondrosarcomas identified between 1974-1989 were reviewed in a retrospective study. The purpose of this study was to examine the morphological characteristics of different types of chondrosarcomas and to describe remarkable features of location, age distribution and male to female ratio. We distinguish four types of centrally located chondrosarcoma: classical chondrosarcomas, dedifferentiated chondrosarcomas, mesenchymal chondrosarcomas and clear cell chondrosarcomas. Five periosteal chondrosarcomas were represented. Classical chondrosarcomas as well as clear cell chondrosarcomas indicate a significant predominance of males; no sex predilection in dedifferentiated and mesenchymal chondrosarcomas was seen. Nearly 60% of classical and mesenchymal chondrosarcomas occur in the trunk. 85% of dedifferentiated chondrosarcomas are located in the long bones of the limbs. The most common location of clear cell chondrosarcoma is the proximal part of the femur. There is a marked predilection for mesenchymal chondrosarcomas in the second and third decades of life. The mean age of patients with classical chondrosarcomas was 54 years, but clear cell chondrosarcomas occur 10 years earlier and dedifferentiated chondrosarcomas 10 years later. Characteristically, classical chondrosarcomas produce a pure chondroid matrix with variable differentiation of tumour chondrocytes. The most important histological feature of the dedifferentiated chondrosarcoma is the close association of two different cellular components. One of these consists of cartilage, which is generally well differentiated. In most of our cases the second component showed features of osteosarcoma (50%). Mesenchymal chondrosarcoma is characterized by concentric infiltration of cartilage islands by small tumour cells.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

在一项回顾性研究中,对1974年至1989年间确诊的89例中央型软骨肉瘤和5例骨膜软骨肉瘤进行了分析。本研究旨在探讨不同类型软骨肉瘤的形态学特征,并描述其位置、年龄分布和男女比例的显著特点。我们将中央型软骨肉瘤分为四种类型:经典型软骨肉瘤、去分化型软骨肉瘤、间叶型软骨肉瘤和透明细胞软骨肉瘤。本研究纳入了5例骨膜软骨肉瘤。经典型软骨肉瘤和透明细胞软骨肉瘤均以男性为主;去分化型和间叶型软骨肉瘤无性别差异。近60%的经典型和间叶型软骨肉瘤发生于躯干。85%的去分化型软骨肉瘤位于四肢长骨。透明细胞软骨肉瘤最常见于股骨近端。间叶型软骨肉瘤在20至30岁人群中显著高发。经典型软骨肉瘤患者的平均年龄为54岁,而透明细胞软骨肉瘤患者的发病年龄提前10年,去分化型软骨肉瘤患者的发病年龄推后10年。典型的经典型软骨肉瘤产生纯软骨样基质,肿瘤软骨细胞有不同程度的分化。去分化型软骨肉瘤最重要的组织学特征是两种不同细胞成分紧密相连。其中一种成分是软骨,通常分化良好。在我们的大多数病例中,第二种成分表现为骨肉瘤特征(50%)。间叶型软骨肉瘤的特征是小肿瘤细胞呈同心状浸润软骨岛。(摘要截选至250字)

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