Milgram J W
Department of Orthopaedic Surgery, Northwestern University School of Medicine, Chicago, Illinois 60611.
Clin Orthop Relat Res. 1988 Jun(231):277-302.
Sixty-one cases of histologically confirmed solitary intraosseous lipomas were analyzed with respect to clinical, roentgenographic, gross, and histologic features. Two additional cases with multiple intraosseous sites and three additional cases not treated with surgery are also described. Intraosseous lipomas may be subdivided into three groups depending on the degree of involution: I, solid tumors of viable lipocytes; II, transitional cases with partial fat necrosis and focal calcification but also regions of viable lipocytes; and III, late cases in which the fat cells have died with variable degree of cyst formation, calcification, and reactive new bone formation of a characteristic morphology. The tumor is a well-defined entity that may present with varying features due to its stage of evolution. Thus, lipomas have been confused with other benign tumors, cysts, and cases of bone infarction. Intraosseous lipoma is not as rare as the literature suggests, but has been rarely diagnosed. The lesion appears to undergo spontaneous involution, so that surgical excision may not be necessary in some cases.
对61例经组织学确诊的孤立性骨内脂肪瘤的临床、X线、大体及组织学特征进行了分析。还描述了另外2例多骨内部位的病例以及另外3例未接受手术治疗的病例。骨内脂肪瘤可根据 involution程度分为三组：I，存活脂肪细胞的实体瘤；II，伴有部分脂肪坏死和局灶性钙化但也有存活脂肪细胞区域的过渡病例；III，脂肪细胞已死亡且伴有不同程度囊肿形成、钙化和特征性形态的反应性新骨形成的晚期病例。该肿瘤是一个界限清楚的实体，因其演变阶段不同可能呈现出不同特征。因此，脂肪瘤曾与其他良性肿瘤、囊肿及骨梗死病例相混淆。骨内脂肪瘤并非如文献所提示的那样罕见，只是很少被诊断出来。该病变似乎会自行 involution，因此在某些情况下可能无需手术切除。
