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[地诺单抗治疗骨巨细胞瘤的临床、放射学及病理学特征]

[Clinical, radiologic and pathologic features of giant cell tumor of bone treated with denosumab].

作者信息

Gong L H, Liu W F, Ding Y, Zhang W, Yang Y K, Yu F, Wong G Q, Huang X Y, Niu X H

机构信息

Department of Pathology, Beijing Jishuitan Hospital, Fourth Medical College of Peking University, Beijing 100035, China.

出版信息

Zhonghua Bing Li Xue Za Zhi. 2018 Jun 8;47(6):449-454. doi: 10.3760/cma.j.issn.0529-5807.2018.06.012.

Abstract

To investigate the radiological and histopathological features of giant cell tumor of bone treated with RANKL inhibitor denosumab. Eleven cases were retrieved from the surgical pathology records between March 2015 and June 2017 in Beijing Jishuitan Hospital. Formalin fixed, paraffin embedded specimens were collected and the histological features were evaluated. The imaging features including X ray, magnetic resonance imaging, and computed tomography were also reviewed. These 11 cases of giant cell tumor of bone were derived from five female and six male patients, with age ranged from 20 to 62 years (mean age, 35 years). The tumors were located in the sacrum (6 cases), femur (2 cases), radius (1 case), tibia (1 case) and patella (1 case), respectively. Histologically, all cases showed depletion of giant cells, proliferation of mononuclear cells and different degrees of ossification 3 to 6 months after denosumab therapy. Radiography showed marked osteosclerosis and sclerotic rim formation. Three cases of the sacrum recurred after 5, 6 and 11 months of surgery, and the remaining cases showed no recurrence within follow-up of 1 to 14 months. Denosumab treated giant cell tumors morphologically differ from untreated tumors. Careful attention to a history of denosumab administration is crucial to avoid misdiagnosis and to allow proper differentiation from other tumors and tumor-like lesions.

摘要

研究用核因子κB受体活化因子配体(RANKL)抑制剂地诺单抗治疗骨巨细胞瘤的放射学和组织病理学特征。从北京积水潭医院2015年3月至2017年6月的手术病理记录中检索出11例病例。收集福尔马林固定、石蜡包埋的标本并评估组织学特征。还回顾了包括X线、磁共振成像和计算机断层扫描在内的影像学特征。这11例骨巨细胞瘤患者中,女性5例,男性6例,年龄20至62岁(平均年龄35岁)。肿瘤分别位于骶骨(6例)、股骨(2例)、桡骨(1例)、胫骨(1例)和髌骨(1例)。组织学上,地诺单抗治疗3至6个月后,所有病例均显示巨细胞减少、单核细胞增生以及不同程度的骨化。放射学表现为明显的骨质硬化和硬化边缘形成。3例骶骨肿瘤在术后5、6和11个月复发,其余病例在1至14个月的随访中未复发。地诺单抗治疗的骨巨细胞瘤在形态上与未治疗的肿瘤不同。仔细询问地诺单抗用药史对于避免误诊以及与其他肿瘤和肿瘤样病变进行正确鉴别至关重要。

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