Herrmann H J, Goth D
Handchir Mikrochir Plast Chir. 1983 Jun;15(2):86-91.
This paper deals with the case of a so-called giant-cell reaction of the short tubular bones of a 31 year-old patient. Histologically, this rare benign disease falls under the category of tumor-like lesions of the bone. Clinically, the disease becomes evident through pain and swelling, and radiologically, a lytic bone process can be observed which may well perforate the cortical substance. The therapy consists in the total removal and the filling of the defect with autologous bone graft from the iliac crest, in some cases also by means of some additional autologous cancellous bone chips. The prognosis after surgical therapy is excellent. In the few cases which have to date become known, no cases of recurrence have been observed. Although the pathogenesis has not been clarified, thus far trauma and local disturbances of growth and/or development must be considered. Concerning differential diagnosis, one should distinguish above all the reaction from aneurysmal and juvenile bone cyst, as well as osteoclastoma.
本文探讨了一名31岁患者短管状骨所谓巨细胞反应的病例。从组织学上看,这种罕见的良性疾病属于骨肿瘤样病变范畴。临床上,该疾病通过疼痛和肿胀表现出来,放射学上可观察到溶骨性骨病变,且很可能穿透皮质骨。治疗方法是彻底切除并用取自髂嵴的自体骨移植填充缺损,某些情况下还需添加一些自体松质骨碎片。手术治疗后的预后良好。在迄今为止已知的少数病例中,未观察到复发情况。尽管发病机制尚未阐明,但目前必须考虑创伤以及生长和/或发育的局部紊乱。关于鉴别诊断,首先应将其与动脉瘤性骨囊肿、青少年骨囊肿以及骨巨细胞瘤的反应区分开来。