Markert Eva, Gruber-Moesenbacher Ulrike, Porubsky Christian, Popper Helmut H
Institute of Pathology, Laboratories for Molecular Cytogenetics, Environmental and Pulmonary Pathology, Medical University of Graz, Auenbruggerplatz 25, Graz 8036, Austria.
Virchows Arch. 2006 Jul;449(1):117-20. doi: 10.1007/s00428-006-0205-6. Epub 2006 Apr 26.
Extraskeletal osteomas have not been described in the lung. Tumors with osseous elements can be found, such as hamartoma and amyloid tumor, and reactive lesions such as osseous metaplasia. A 39-year-old male patient was treated for multiple myeloma and got a bone marrow transplantation 2 years and a few months before he presented with a solitary well-circumscribed tumor in the right middle lobe. The patient underwent surgical resection. The tumor presented with a fibrous capsule and consisted of mature bone trabecules. Within the tumor, fatty tissue was seen. There were small bone spicules interpreted as areas of new bone formation and appositional growth. No amyloid deposition, no immature epithelial tubules as in hamartomas, and no normal lung structure as in osseous metaplasia were seen. Within the osseous elements, a positive reaction was seen with antibodies for osteonectin, whereas the reaction for calcitonin was negative. To the best of our knowledge, this is the first case of an osteoma being reported in the lung looking like any other extraskeletal osteoma. This tumor might have been induced by circulating stem cells; however, due to autologous bona marrow transplantation, this cannot be proven.
肺内尚未见有关骨外骨瘤的报道。肺内可见含有骨成分的肿瘤,如错构瘤和淀粉样瘤,以及诸如骨化生等反应性病变。一名39岁男性患者曾接受多发性骨髓瘤治疗,并在出现右中叶孤立性边界清晰的肿瘤前2年零数月接受了骨髓移植。患者接受了手术切除。肿瘤有纤维性包膜,由成熟骨小梁组成。肿瘤内可见脂肪组织。可见小骨针,被认为是新骨形成和表面生长区域。未见淀粉样物质沉积,未见错构瘤中那样的未成熟上皮小管,也未见骨化生中那样的正常肺结构。在骨成分内,骨连接蛋白抗体呈阳性反应,而降钙素反应为阴性。据我们所知,这是首例报道的肺内骨瘤,其表现与其他任何骨外骨瘤相似。该肿瘤可能由循环干细胞诱导产生;然而,由于是自体骨髓移植,这一点无法得到证实。