Raharjo Paulus, Setiawati Rosy
Study Program of Radiology, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia.
Department of Radiology, Faculty of Medicine, Universitas Airlangga - Dr. Soetomo General Academic Hospital, Surabaya, Indonesia.
Ann Med Surg (Lond). 2022 Jun 29;79:104111. doi: 10.1016/j.amsu.2022.104111. eCollection 2022 Jul.
Giant cell tumor (GCT) of the bone in elderly patients is a very rare bone tumor.
Radiography of the left antebrachial revealed a lytic lesion, septated, having a soap bubble appearance in the distal epi-meta-diaphysis of the left radius, narrow transitional zone, type-IB geographic destruction, with cortical thinning, no periosteal reaction, no calcified matrix, with soft tissue involvement. MRI examination of the left antebrachial showed a lesion with partially ill-defined margins, irregular margins, in the left distal epi-meta-diaphysis, accompanied by soft tissue protrusion, which was hypointense on T1WI, iso to hyperintense on T2WI/FAT SAT which partially formed fluids level, the area of diffusion was limited on DWI. After the administration of contrast administration, improvement appeared, the lesion appeared to extend to the articular surface of the left radius bone. Histopathological examination showed the distribution and clusters of mononuclear cells, round oval nuclei, fine chromatin, the distribution of multinucleated giant cells with >10 nuclei similar to mononuclear cell nuclei. These findings were keys as giant bone tumor cells.
A specific examination of the GTC in the elderly needs to be carried out to minimize misdiagnosis.
Giant cell tumor is also possible be found in elderly patients. Diagnosis is based on clinical findings, radiological examination, and confirmed by histopathology.
老年患者的骨巨细胞瘤是一种非常罕见的骨肿瘤。
左前臂X线检查显示桡骨远端骨骺 - 干骺端有一溶骨性病变,呈分隔状,呈肥皂泡样外观,移行带狭窄,为IB型地图样破坏,皮质变薄,无骨膜反应,无钙化基质,伴有软组织受累。左前臂MRI检查显示左桡骨远端骨骺 - 干骺端有一病变,边界部分不清、不规则,伴有软组织突出,T1WI呈低信号,T2WI /脂肪抑制序列呈等信号至高信号,部分形成液平,DWI上扩散受限。增强扫描后病变有强化,似乎延伸至左桡骨的关节面。组织病理学检查显示单核细胞分布及聚集,核呈圆形或椭圆形,染色质细腻,多核巨细胞分布,核数>10个,与单核细胞核相似。这些表现是骨巨细胞瘤细胞的关键特征。
对老年患者的骨巨细胞瘤需要进行特异性检查以尽量减少误诊。
老年患者也可能发生骨巨细胞瘤。诊断基于临床表现、影像学检查,并经组织病理学证实。