Higaki S, Takeyama S, Tateishi A, Machinami R, Abe M
Nihon Seikeigeka Gakkai Zasshi. 1981 Jul;55(7):647-64.
Benign chondroblastoma, a rare bone tumor clinically and histologically resembles giant cell tumor. We have experienced twenty-two cases of histologically confirmed benign chondroblastoma over the 25 year period from 1952 to 1978. The age of the patients ranged from 10 to 46 years, with an average of 20 years. Fifteen cases were in the second decade. Males were predominant to females with a ratio of 2.7:1. Location of the tumor varied widely. The tumor was located in the long bones in 18 out of 22 and limited to the epiphysis in 15. Detailed histological examination in twelve cases with hematoxylin-eosin, alucian blue, toluidine blue, silver impregnation and safranin-O staining, revealed positive staining with alucian blue and PAS. PAS positive granules wee found within cytoplasm and identified as glycogen granules by electron microscopy. However, metachromasia was not always positive and none of these cases stained positive with safranin-O. Rich reticulin fibers encircled each tumor cell and each group of cells. Electronmicroscopic study of 4 cases revealed two types of giant cells. The cell membrane had many microvilli-like protrusions, and the nuclei of the tumor cells were irregular in appearance and had large indentations. Sometimes many fine filaments and electron dense fine granules were observed in intercellular chondroid space. Morphological study of cultured cells was done in two cases. Morphology of these tumor cells proved to be different from fibroblasts, cultured chondrocytes and macrophages. Tumor cells moved rapidly and had undulating membranes at the pseudopodia. From these findings, we speculated that the origin of the benign chondroblastoma cell may be histiocytic cells. Surgical treatment of this tumor was carried out as follows. Curettage was performed in 16 cases, with bone graft in 15, resection 4 and amputation in two. Recurrence was noted on two cases, although no further recurrence occurred after reoperations for nine and twelve years respectively.
良性软骨母细胞瘤是一种临床和组织学上均罕见的骨肿瘤，类似于巨细胞瘤。在1952年至1978年的25年期间，我们共经历了22例经组织学确诊的良性软骨母细胞瘤。患者年龄在10岁至46岁之间，平均年龄为20岁。其中15例在第二个十年。男性多于女性，比例为2.7:1。肿瘤位置差异很大。22例中有18例位于长骨，15例局限于骨骺。对12例进行苏木精-伊红、阿利新蓝、甲苯胺蓝、银浸染和番红O染色的详细组织学检查显示，阿利新蓝和PAS染色呈阳性。PAS阳性颗粒见于细胞质内，经电子显微镜鉴定为糖原颗粒。然而，异染性并非总是呈阳性，且这些病例中无一例番红O染色呈阳性。丰富的网状纤维环绕着每个肿瘤细胞和每组细胞。对4例进行的电子显微镜研究显示有两种类型的巨细胞。细胞膜有许多微绒毛样突起，肿瘤细胞核外观不规则，有大的凹陷。有时在细胞间软骨样间隙中观察到许多细丝和电子致密的细颗粒。对2例进行了培养细胞的形态学研究。这些肿瘤细胞的形态证明与成纤维细胞、培养的软骨细胞和巨噬细胞不同。肿瘤细胞移动迅速，伪足处有起伏的膜。根据这些发现，我们推测良性软骨母细胞瘤细胞的起源可能是组织细胞。该肿瘤的手术治疗如下。16例行刮除术，15例植骨，4例切除，2例行截肢术。有2例复发，不过分别在再次手术后9年和12年未再复发。
