Lang S
Klinisches Institut für Pathologie, Universitätsklinik Wien, Währinger Gürtel 18-20, 1090 Wien, Osterreich.
Pathologe. 2008 Nov;29 Suppl 2:245-9. doi: 10.1007/s00292-008-1090-3.
The diagnosis of giant cell-rich lesions of bone is often problematic even for the experienced pathologist. The diagnostic key lies in multinucleated osteoclast-like giant cells and a mononuclear stroma. From the histological picture alone it is often difficult to distinguish between individual entities such as conventional giant-cell tumor of bone, non-ossifying fibroma, giant-cell tumor in hyperparathyroidism or an aneurysmal bone cyst. Furthermore, these lesions can be confused with malignant bone tumors such as giant cell-rich osteosarcoma. X-ray is important for a correct diagnosis since some of these tumors show a typical anatomic location, while age of the patient is also an important factor. In most cases diagnosis is made on the basis of intraoperative frozen-section, but even in this setting, due to the poor quality of the material, it is very difficult to make a correct diagnosis of giant cell-rich lesions without X-ray and clinical data.
即使对于经验丰富的病理学家而言，骨巨细胞丰富性病变的诊断通常也存在问题。诊断的关键在于多核破骨细胞样巨细胞和单核基质。仅从组织学图像往往很难区分诸如骨的传统巨细胞瘤、非骨化性纤维瘤、甲状旁腺功能亢进中的巨细胞瘤或动脉瘤样骨囊肿等个体实体。此外，这些病变可能会与恶性骨肿瘤如富含巨细胞的骨肉瘤相混淆。X线对于正确诊断很重要，因为其中一些肿瘤显示出典型的解剖位置，而患者的年龄也是一个重要因素。在大多数情况下，诊断基于术中冰冻切片，但即使在这种情况下，由于材料质量差，在没有X线和临床数据的情况下很难对巨细胞丰富性病变做出正确诊断。
