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骨软骨母细胞瘤的临床病理分析、免疫组织化学研究及电子显微镜观察

[Clinicopathological analysis, immunohistochemical study and electron microscopic observation of chondroblastoma of bone].

作者信息

Wang L T

机构信息

Sun Yatsen University of Medical Sciences, Guangzhou.

出版信息

Zhonghua Wai Ke Za Zhi. 1993 Dec;31(12):717-21.

PMID:8033700
Abstract

A series of 73 cases of chondroblastoma of bone, a rare benign tumor, was subjected to clinicopathological analysis, 50 cases of it were studied by immunohistochemistry and affinity histochemistry and 3 cases were observed by electron microscopy. In this series, chondroblastomas were found nearly in patients of all age groups, with the peak incidence occurring in the second decade of life. The lesions were more commonly located in long bone metaphyseal portion, especially in the upper end of femur and the head and neck of femur. It was easily misdiagnosed as giant cell tumor of bone, chondroma, and osteochondroma by clinic and radiography. There was gradual transition from a few chondroblasts to a small focus of clear cells in 3 cases, therefore, chondroblastoma may transform into clear cell chondrosarcoma by anaplastic change of chondroblast, which is one of malignant chondroblastomas. Our immunohistochemistry and affinity histochemistry results supported the point of view of chondroblast originated from epiphyseal chondrocytes. Immunohistochemical assessment of S-100 protein may be one useful parameter for differentiating chondroblastoma from giant cell tumor of bone and aneurysmal bone cyst ultrastructurally, chondroblasts had characteristic lobulated nuclei, compact zones under nuclear membrane, and microvilli on cells surface. In most cells, the Golgi apparatus and RER were inconspicuous without.

摘要

对73例骨软骨母细胞瘤(一种罕见的良性肿瘤)进行了临床病理分析,其中50例进行了免疫组织化学和亲和组织化学研究,3例进行了电镜观察。在这组病例中,各年龄组患者均有骨软骨母细胞瘤发生,发病高峰在第二个十年。病变多位于长骨的干骺端,尤其是股骨上端和股骨头颈部。临床和影像学检查时,它很容易被误诊为骨巨细胞瘤、软骨瘤和骨软骨瘤。3例中可见从少数软骨母细胞逐渐过渡到小灶性透明细胞,因此,骨软骨母细胞瘤可能通过软骨母细胞的间变转化为透明细胞软骨肉瘤,这是恶性软骨母细胞瘤之一。我们的免疫组织化学和亲和组织化学结果支持骨软骨母细胞起源于骨骺软骨细胞的观点。S-100蛋白的免疫组织化学评估可能是将骨软骨母细胞瘤与骨巨细胞瘤和动脉瘤样骨囊肿相鉴别的一个有用参数。在超微结构上,软骨母细胞有特征性的分叶状核、核膜下致密区和细胞表面微绒毛。在大多数细胞中,高尔基体和粗面内质网不明显。

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