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诊断干燥骨上前列腺癌转移灶的难题

The Difficult Task of Diagnosing Prostate Cancer Metastases on Dry Bone.

作者信息

Castoldi Elisa, Cappella Annalisa, Gibelli Daniele, Sforza Chiarella, Cattaneo Cristina

机构信息

LABANOF - Laboratorio di Antropologia e Odontologia Forense, Sezione di Medicina Legale, Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Luigi Mangiagalli 37, 20133, Milan, Italy.

Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Luigi Mangiagalli 31, 20133, Milan, Italy.

出版信息

J Forensic Sci. 2018 May;63(3):672-682. doi: 10.1111/1556-4029.13617. Epub 2017 Aug 17.

Abstract

The interpretation of pathology on skeletal remains is mandatory for implementing the biological profile and for disease recognition. Prostate cancer is one of the most common tumors, with a high preference for the skeleton as a primary site of metastasis. Its diagnosis on bone is however still ambiguous, due to its "osteoblastic" and resorptive manifestation. This study investigates distribution and appearance of prostate cancer metastases on dry bone on six known cases (selected from the Milano Cemetery Skeletal Collection) and one healthy individual. A macroscopic inspection was performed highlighting the abnormalities observed, describing location, shape, dimension, and aspect. A great amount of proliferative and mixed lesions was noticed, but also cases of pure lytic lesions were displayed. The multiple appearances of the manifestations observed display the difficulty in correctly identifying such a pathology, but also the potential and advantages provided by investigating a study sample with known antemortem history.

摘要

对骨骼遗骸进行病理学解读对于构建生物学特征和疾病识别至关重要。前列腺癌是最常见的肿瘤之一,极易转移至骨骼并将其作为主要转移部位。然而,由于其“成骨”和吸收性表现,在骨骼上的诊断仍不明确。本研究调查了6例已知病例(选自米兰公墓骨骼收藏)和1例健康个体的干燥骨骼上前列腺癌转移灶的分布和外观。进行了宏观检查,突出观察到的异常情况,描述其位置、形状、尺寸和外观。发现了大量增殖性和混合性病变,也有纯溶解性病变的病例。观察到的表现形式多样,这表明正确识别这种病理情况存在困难,但也显示了研究具有已知生前病史的样本所带来的潜力和优势。

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