Department of Orthopaedic Surgery, Saint-Luc University Hospital, Université Catholique de Louvain, Brussels, Belgium.
Arch Orthop Trauma Surg. 2010 Apr;130(4):481-7. doi: 10.1007/s00402-009-0887-8. Epub 2009 May 9.
Aneurysmal bone cyst is a benign lesion occurring in young patients which frequently recurs after treatment. Biopsy is mandatory for the diagnosis of a putative aneurysmal bone cyst as this lesion can be secondary to another underlying process including a malignant bone tumour. The histopathological features of aneurysmal bone cysts have been examined with the goal of finding relevant criteria for predicting favourable evolution or recurrence of the disease.
Twenty-one biopsies of surgically treated aneurysmal bone cysts, from 21 patients, were analysed. Histomorphometry by two different methods (3,000- and 200-point-counting) and by two observers was performed to quantify the percentage of each tissue type in the cyst (cellular, fibrillar, osteoid). A healing index was developed by calculating a ratio of osteoid and fibrillar material divided by cellular tissue. Biopsies were also examined using two immunostains, cluster of differentiation 68 (CD68) and proliferating cell nuclear antigen (PCNA).
The final outcome was healing for 16 aneurysmal bone cysts (healing group) and recurrence for the five others (recurrence group), after a mean follow-up of 4.43 years. The two groups differed significantly in the proportion of their cellular content and their healing index. The ratio of CD68 negative to CD68 positive cells was also significantly different between the two groups.
Biopsy should be considered as a helpful prognostic factor for aneurysmal bone cyst.
动脉瘤样骨囊肿是一种发生于年轻患者的良性病变，在治疗后常复发。为明确诊断可能的动脉瘤样骨囊肿，活检是必需的，因为该病变可能继发于其他潜在疾病，包括恶性骨肿瘤。人们研究了动脉瘤样骨囊肿的组织病理学特征，以期找到预测疾病转归或复发的相关标准。
分析了 21 例接受手术治疗的动脉瘤样骨囊肿患者的 21 份活检样本。采用两种不同的方法（3000 点和 200 点计数法）和两位观察者进行组织形态计量学分析，以定量评估囊内每种组织类型（细胞、纤维、类骨质）的比例。通过计算类骨质和纤维物质与细胞组织的比值，建立了愈合指数。还使用两种免疫染色（CD68 和增殖细胞核抗原（PCNA））对活检样本进行了检查。
平均随访 4.43 年后，16 例动脉瘤样骨囊肿（愈合组）最终结果为愈合，5 例（复发组）复发。两组在细胞含量和愈合指数方面存在显著差异。两组 CD68 阴性细胞与 CD68 阳性细胞的比值也存在显著差异。
活检可作为预测动脉瘤样骨囊肿的一种有帮助的预后因素。
