Vanel D, Couanet D, Micheau C, Piekarski J D, Schwaab G, Masselot J
Skeletal Radiol. 1980 Apr;5(2):99-103. doi: 10.1007/BF00347329.
Clinical, radiological, and histological problems arise relating to fibrous dysplasia of the maxilla. Clinically, 11 of our 39 cases developed so rapidly that the lesions were suspected of being malignant. The histological diagnosis may be very difficult, since any tumoural, reactive, or healing process may simulate fibrous dysplasia. As a general rule, the diagnosis is established most easily by the radiological examination. The radiologist's responsibility is important, as mistakes may have serious consequences. We report four pseudotumoural forms of maxillary sinus fibrous dysplasia. All were characterised clinically by rapid evolution, radiologically by opacity of the sinus with apparent destruction of its wall, and histologically by difficulty in establishing the diagnosis. In two cases indeed, the initial histological interpretation was an osteogenic sarcoma. Due to its excellent densitometric resolution, computed tomography provides an invaluable contribution by displaying the fibrous wall of an intact or even thickened maxillary sinus when conventional radiology has suggested a destructive process. In difficult cases of maxillary fibrous dysplasia, computed tomography should be used as a supplementary investigation to establish the correct diagnosis.
上颌骨纤维发育异常会引发临床、放射学及组织学方面的问题。临床上，我们39例患者中有11例病情发展迅速，以至于病变被怀疑为恶性。组织学诊断可能非常困难，因为任何肿瘤性、反应性或愈合过程都可能模拟纤维发育异常。一般来说，通过放射学检查最容易确立诊断。放射科医生的责任很重要，因为错误可能会产生严重后果。我们报告了四例上颌窦纤维发育异常的假瘤样形式。所有病例在临床上均表现为病情迅速发展，放射学上表现为窦腔混浊且窦壁明显破坏，组织学上表现为难以确立诊断。实际上，在两例病例中，最初的组织学诊断为骨肉瘤。由于其出色的密度分辨率，当传统放射学提示有破坏过程时，计算机断层扫描通过显示完整甚至增厚的上颌窦纤维壁提供了宝贵的帮助。在诊断困难的上颌骨纤维发育异常病例中，计算机断层扫描应作为辅助检查手段以确立正确诊断。
