骨化纤维瘤,ossifying fibroma,是指骨的纤维结构(纤维性和骨样物质组成)出现异常改变,骨化指纤维组织间有大量纤细的条状新生骨,骨小梁周围有较多活跃的骨母细胞。常见于青少年(小于10岁),女性多于男性,多为单发病灶。常见于下肢长骨(胫骨多见,腓骨少见),其次是颌骨(下颌骨多见)。
You may better understand this condition when you break down the definitions of each word.
Ossifying is the medical term for changing into bone. With ossifying fibroma, bone develops within fibrous connective tissue where it doesn’t belong.
Fibroma refers to the fibrous tissue that makes up the tumor. Healthcare providers use the suffix “-oma” to refer to all tumors, regardless of whether they’re cancerous (malignant).
骨化性纤维瘤属于良性骨肿瘤,生长缓慢,早期无症状,随着病情发展,可有颌骨畸形,并累及上颌窦及邻近组织;发生在胫腓骨,可有弯曲表现。
CEMENTO OSSIFYING FIBROMA
骨化纤维瘤多为实性,囊性少见,镜下见大量的、排列成束和漩涡状的纤维组织,其中含有一些大小不等、排列不规则的骨小梁和钙化灶,骨小梁周围有少数成骨细胞,并含有骨样组织。通俗地讲,
X线检查,病变发生于骨干或近干骺端一侧皮质骨内,不累及骨骺,病灶呈偏心性膨胀性改变,多为不规则的单囊或多囊形,轮廓清晰,边缘硬化,病变一般不穿破骨皮质,无骨膜反应。晚期肿瘤组织逐渐骨化而密度增高,病灶内无钙化。病变范围广泛,骨骼可有畸形。
CT检查,骨皮质内囊状低密度影,其间常有增生骨化高密度影,骨皮质不规则增厚,可向髓腔内突出,导致髓腔变形、变小,甚至闭塞。
MRI检查,多数病灶在T1低信号,T2低信号。
病理检查,病变组织灰白色,有砂砾感。镜下病变由纤维组织和骨小梁构成。纤维母细胞和纤维细胞呈无定形排列,骨小梁形状不规则,周围被成排的骨母细胞包绕,偶尔可见破骨细胞,肿瘤的中央部常见编织骨,其外周逐渐向板状骨过度。
An ossifying fibroma is a rare noncancerous (benign) tumor that mostly affects your jawbones. It causes a tumor made of bone-like substances to form within connective tissue. These tumors don’t always cause symptoms, but treatment is a must. They can destroy healthy bone and cause dental problems. You’ll need oral surgery to remove the tumor.
An ossifying fibroma lesions like ossifying fibromas occur when
fibrous tissue that contains a bone-like substance replaces healthy
bone.
Ossifying fibromas are benign bone lesions that should be differentiated from non-ossifying fibromas and fibrous dysplasia. Osteofibrous dysplasia is
considered as a separate pathological entity in view of its different
presentation and treatment, although histopathologically similar to
ossifying fibroma.
鉴别诊断
骨纤维异常增殖症,病变在骨髓腔内,中心性膨胀,边界不清,X线表现为磨砂玻璃样改变。骨小梁仅成熟到编织骨阶段,见不到板状骨,未成熟的骨小梁周围是纤维组织,无骨母细胞覆盖。
骨巨细胞瘤,病变位于骨骺线闭合处,病灶内无骨化影。
骨母细胞瘤,病变位于骺端呈小圆形低密度阴影,边界清楚,周围有反应骨形成硬化缘,病灶内可见点状钙化。
非骨化性纤维瘤,non-ossifying fibroma,由组织成纤维细胞组成的干骺端错构瘤,病变扩展侵入髓腔而且常合并病理性骨折。非骨化性纤维瘤最常见于儿童及青少年。非骨化性纤维瘤典型的X线特征,始于长骨的干骺端,靠近骺板,在一侧皮质上膨胀、偏心性,随骨的生长发育病变可以逐渐向骨干移行,病灶内为界限清楚透亮阴影,呈分叶状卵圆形,周边有一硬化缘。病变纵轴与长骨一致。
Non-ossifying fibromas are the most common benign bone tumor in
children, affecting up to 40%. They are made of fibrous tissue and grow
on long bones, especially the legs. They usually appear as a solitary
growth. They don’t spread or turn to cancer. Non-ossifying fibromas go
away on their own when the child has fully grown.
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