de Chadarévian Jean-Pierre, Katsetos Christos D, Pascasio Judy M, Geller Evan, Herman Martin J
Department of Pathology and Laboratory Medicine, St. Christopher's Hospital for Children and Drexel University College of Medicine, Philadelphia, PA 19134, USA.
Pediatr Dev Pathol. 2007 Sep-Oct;10(5):358-68. doi: 10.2350/06-07-0133.1.
The osteoid osteoma is a painful lesion with a special predilection for the femur and tibia of young patients. Although the lesion has been described as richly innervated, its vascular supply has not been critically appraised to date in the pathology literature. To this end, we have undertaken a morphological study of 16 archival cases of osteoid osteoma, focusing primarily on the patterns of vascularization, utilizing traditional histological and immunohistochemical approaches. The study demonstrated that a prominent arterial and arteriolar blood supply was a constant finding within the various zones of soft tissues, skeletal muscle, and bone surrounding the nidus. It also showed that the caliber of the vessels underwent gradual attenuation throughout their centripetal course toward the nidus, where the vessels lost their muscularis as they merged into the capillary network of the nidus. Immunostaining with antibodies to neurofilament and S100 proteins revealed a pattern of innervation that was overall less exuberant than that described in some reports and that was virtually absent from the nidus. Taken together with data reported in the radiological literature, our findings lead us to wonder whether the osteoid osteoma may represent a response to the local stimulation of bony tissue by a primarily aberrant vasculature, a hypothesis that warrants further elucidation using state-of-the-art imaging approaches.
骨样骨瘤是一种疼痛性病变，特别好发于年轻患者的股骨和胫骨。尽管该病变被描述为神经支配丰富，但其血管供应在病理学文献中至今尚未得到严格评估。为此，我们对16例骨样骨瘤存档病例进行了形态学研究，主要利用传统组织学和免疫组化方法，重点关注血管形成模式。研究表明，在病灶周围的软组织、骨骼肌和骨的各个区域内，始终能发现显著的动脉和小动脉血液供应。研究还显示，血管口径在向病灶中心的行程中逐渐变细，在病灶处，血管汇入病灶的毛细血管网时失去肌层。用神经丝和S100蛋白抗体进行免疫染色显示，其神经支配模式总体上不如某些报告中描述的那样丰富，病灶处几乎没有神经支配。结合放射学文献报道的数据，我们的研究结果使我们不禁要问，骨样骨瘤是否可能是主要异常的脉管系统对骨组织局部刺激的一种反应，这一假说有待使用先进的成像方法进一步阐明。
