Ruiter D J, van Rijssel T G, van der Velde E A
Cancer. 1977 May;39(5):2231-9. doi: 10.1002/1097-0142(197705)39:5<2231::aid-cncr2820390541>3.0.co;2-q.
A clinicopathological review of 105 cases of aneurysmal bone cyst is reported. Age and sex distribution and localization were in agreement with two previously reported large series. Recurrence occurred in 30.5% of all the cases and in 34.2% of those treated by curettage. Proved incompleteness of surgical removal was an important factor in recurrence (12 out of 17 cases or 70.6%). The recurrence rate was significantly (P2 less than 0.01) higher in cases with a mitotic index of seven or more per 50 fields (X 750) than in those with a lower mitotic index. In relation to the recurrence rate, no statistically significant differences were found between the age groups less than or equal to 15 and greater than 15 years, between the combination age and lesion size, or between four localization groups. The cyst wall and the septa consist of a superficial layer of cellular fibroblastic and histiocytic tissue in which multinuclear giant cells are present, covering a deeper situated zone of less cellular fibrous tissue. This typical layered architecture was found at one or more places in 93 (88.6%) out of 105 cases. However, layered architecture may also be found in cases of teleangiectatic osteosarcoma. It is suggested that the group with a high risk of recurrence be treated more radically, i.e., with cryosurgery.
本文报道了105例动脉瘤样骨囊肿的临床病理回顾。年龄、性别分布及病变部位与之前报道的两个大样本系列研究结果一致。所有病例的复发率为30.5%，刮除术治疗病例的复发率为34.2%。手术切除不彻底是复发的重要因素（17例中有12例，占70.6%）。每50个视野（×750）有丝分裂指数为7或更高的病例复发率显著（P2＜0.01）高于有丝分裂指数较低的病例。就复发率而言，年龄小于或等于15岁与大于15岁的年龄组之间、年龄与病变大小的组合之间以及四个病变部位组之间均未发现统计学上的显著差异。囊肿壁和间隔由含有多核巨细胞的表层细胞性成纤维细胞和组织细胞组织组成，覆盖着更深层细胞较少的纤维组织区域。105例中有93例（88.6%）在一个或多个部位发现了这种典型的分层结构。然而，在毛细血管扩张性骨肉瘤病例中也可能发现分层结构。建议对复发风险高的患者采用更激进的治疗方法，即冷冻手术。
