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软骨发育不全

Hypochondrogenesis.

作者信息

Maroteaux P, Stanescu V, Stanescu R

出版信息

Eur J Pediatr. 1983 Oct;141(1):14-22. doi: 10.1007/BF00445662.

Abstract

Three clinicopathological observations of a mild form of type II achondrogenesis are presented. The cases were selected from a group of 21 similar cases to illustrate the various degrees of clinical and roentgenological signs that can be found. The cases had various survival periods after birth but not exceeding several months. The roentgenological signs were less severe than those of type II achondrogenesis. Some cases similar to case no. 3 have roentgenological signs very close to spondylo-epiphyseal dysplasia congenita and probably were confused previously with the latter. The name of hypochondrogenesis was proposed for these cases because the lesions of the growth plate are similar although less marked to those found in type II achondrogenesis: high cellularity with poor matrix development; irregular columnization and vascular penetration; large chondrocytes and even more enlarged lacunae; large sclerotic cartilage canals. The clinical and roentgenological diagnosis of hypochondrogenesis could be difficult especially in the less severe forms. The delay in vertebral ossification, the absence of all the epiphyseal nuclei and of the tarsal bones might suggest the diagnosis of hypochondrogenesis, rather than that of spondyloepiphyseal dysplasia. The evolution which seems to be always lethal in a period of several weeks or months would make the diagnosis still more likely and it could be confirmed by histopathological examination. Cases of spondylo-epiphyseal dysplasia congenita might have at birth, roentgenological signs indistinguishable from those of hypochondrogenesis, as was illustrated by case no. 4.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

本文报告了3例轻度II型软骨发育不全的临床病理观察结果。这些病例选自一组21例类似病例,以说明可能出现的各种程度的临床和放射学征象。这些病例出生后的存活时间各不相同,但均不超过数月。其放射学征象比II型软骨发育不全的征象要轻。一些与病例3相似的病例,其放射学征象与先天性脊椎骨骺发育不良非常接近,以前可能被误诊为后者。之所以为这些病例提出低软骨发育不全这一名称,是因为生长板的病变与II型软骨发育不全相似,只是程度较轻:细胞密度高但基质发育差;柱状排列不规则且有血管侵入;软骨细胞大,陷窝甚至更大;硬化软骨管大。低软骨发育不全的临床和放射学诊断可能困难,尤其是在症状较轻的病例中。椎体骨化延迟、所有骨骺核及跗骨缺如可能提示低软骨发育不全的诊断,而非脊椎骨骺发育不良。在数周或数月内似乎总是致命的病情发展会使诊断的可能性更大,组织病理学检查可证实诊断。如病例4所示,先天性脊椎骨骺发育不良的病例在出生时,其放射学征象可能与低软骨发育不全难以区分。(摘要截取自250字)

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