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[棕色瘤:临床、病理及影像学表现]

[Brown tumor: clinical, pathological and imaging manifestations].

作者信息

Fang Yijie, Hong Guobin, Lu Huifang, Guo Yongfei, Yu Wen, Liu Xueguo

机构信息

Department of Radiology, the Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai 519000, China.

Email:

出版信息

Zhonghua Yi Xue Za Zhi. 2015 Dec 1;95(45):3691-4.

PMID:26849934
Abstract

OBJECTIVE

To explore the clinical, pathological characteristics and imaging manifestations of brown tumors caused by hyperparathyroidism, to improve the cognition of the disease.

METHODS

The clinical, pathological characteristics and imaging manifestations of 15 cases of pathologically confirmed brown tumors were retrospectively reviewed. To analyze the imaging and pathological correlations, in addition, between the primary and secondary hyperparathyroidism led to brown tumors differential diagnoses. Rseults: In the 15 cases, aged from 26 to 66 years with median age of 51 years, 7 cases were caused by primary hyperparathyroidism, 8 cases secondary to long-term hemodialysis. Of the 15 cases(total of 34 lesions), 11 cases were multi-part bone involved. 13 of 15 patients for osteoporosis and 2 cases were osteosclerosis.32 lesions had bone destruction, 26 lesions showed expansive bone destruction, 6 showed soluble bone destruction, 12 lesions had harden edge. 23 lesions in bone destruction had calcification or ossification internal. 13 cases with soft tissue mass, enhanced significantly can be found in 3 cases. 2 lesions occured in the skull, bone density increased and the plate edge blur. pathological findings fibrous tissue , rich in blood vessels, scattered hemosiderin deposition, osteoid tissue around it.

CONCLUSION

Brown tumor has relatively specific clinical history and laboratory characteristics. The imaging features include harden edge, in bone destruction has calcification or ossification internal and with soft tissue mass some enhanced significantly. The secondary brown tumor more multi-part destruction and more vertebra were involved than the primary.We can find osteosclerosis in secondary brown tumor. Those characteristic features were important to help for the diagnosis of the brown tumor.

摘要

目的

探讨甲状旁腺功能亢进所致棕色瘤的临床、病理特点及影像学表现,提高对该疾病的认识。

方法

回顾性分析15例经病理证实的棕色瘤患者的临床、病理特点及影像学表现。分析影像学与病理的相关性,此外,对原发性和继发性甲状旁腺功能亢进所致棕色瘤进行鉴别诊断。结果:15例患者年龄26~66岁,中位年龄51岁,其中7例由原发性甲状旁腺功能亢进引起,8例继发于长期血液透析。15例(共34个病灶)中,11例为多部位骨骼受累。15例患者中13例有骨质疏松,2例有骨质硬化。32个病灶有骨质破坏,26个病灶呈膨胀性骨质破坏,6个呈溶解性骨质破坏,12个病灶边缘硬化。23个骨质破坏病灶内部有钙化或骨化。13例有软组织肿块,其中3例可见明显强化。2个病灶发生于颅骨,骨质密度增高,板障边缘模糊。病理表现为纤维组织,血管丰富,散在含铁血黄素沉积,其周围有类骨组织。

结论

棕色瘤有相对特异的临床病史及实验室特征。影像学表现为边缘硬化,骨质破坏内部有钙化或骨化,部分有明显强化的软组织肿块。继发性棕色瘤较原发性多部位破坏且更多累及椎体,继发性棕色瘤可见骨质硬化。这些特征对棕色瘤的诊断有重要帮助。

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