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中华口腔医学研究杂志(电子版) ›› 2019, Vol. 13 ›› Issue (02) : 108 -113. doi: 10.3877/cma.j.issn.1674-1366.2019.02.008

所属专题: 文献

临床研究

颌骨骨肉瘤3例及文献复习
谭丽珊1,(), 陈智慧1, 陈玉英1, 吴立琦1, 郭慧1   
  1. 1. 广东省韶关市第一人民医院病理科 512000
  • 收稿日期:2018-12-06 出版日期:2019-04-01
  • 通信作者: 谭丽珊

Osteosarcoma of the jaws: study and literature review with 3 cases

Lishan Tan1,(), Zhihui Chen1, Yuying Chen1, Liqi Wu1, Hui Guo1   

  1. 1. Department of Pathology, The First People′s Hospital of Shaoguan, Shaoguan 512000, China
  • Received:2018-12-06 Published:2019-04-01
  • Corresponding author: Lishan Tan
  • About author:
    Corresponding author: Tan Lishan, Email:
引用本文:

谭丽珊, 陈智慧, 陈玉英, 吴立琦, 郭慧. 颌骨骨肉瘤3例及文献复习[J/OL]. 中华口腔医学研究杂志(电子版), 2019, 13(02): 108-113.

Lishan Tan, Zhihui Chen, Yuying Chen, Liqi Wu, Hui Guo. Osteosarcoma of the jaws: study and literature review with 3 cases[J/OL]. Chinese Journal of Stomatological Research(Electronic Edition), 2019, 13(02): 108-113.

目的

探讨颌骨骨肉瘤的临床病理特征、诊断及鉴别诊断方法,并进行相关文献复习。

方法

回顾性分析韶关市第一人民医院3例颌骨骨肉瘤临床资料,结合影像学特点,分析该病光学显微镜下的形态特征和免疫组化结果,并进行相关文献复习。

结果

3例颌骨骨肉瘤,病例1发生于左上颌、病例2发生于左下颌,病例1、病例2病理诊断为颌骨普通型骨肉瘤;病例3发生于右下颌,诊断为颌骨低级别中心性骨肉瘤。颌骨骨肉瘤在临床上十分少见,与长骨骨肉瘤相比有其自身特点。

结论

颌骨骨肉瘤在发病年龄,镜下特征均有所不同,临床上要注意与良性骨病相鉴别,需结合临床特征、影像学及病理镜下形态综合考虑。

Objective

To investigate the clinicopathological features of the osteosarcoma in the jaws bones and its diagnosis, differential diagnosis and literature review.

Methods

A retrospective study was made on 3 cases of osteosarcoma of the jaws in our hospital, combined with the imaging materials, to study the microscopical histology and review the literature.

Results

In case 1 the tumor located in the left maxilla and in case 2 the tumor located in the left mandible. Both two cases were diagnosed as conventional osteosarcoma. In case 3 the lesion located in the right mandible and it was diagnosed as low-grade central osteosarcoma. The osteosarcoma of the jaws bones is rare in clinic, and it has its own characteristic compared with osteosarcoma of long bone.

Conclusions

The osteosarcoma of the jaws have its characteristic in age of onset andmicroscopical histology. It is necessary to be differentiated from benign bone diseases with data of clinical features, radiology and pathological microscopic morphology.

图1 病例1(左侧上颌骨骨肉瘤)CT影像及组织病理图片 A:CT影像示左侧鼻腔、左上颌窦及中下鼻甲骨质破坏;B:多角形及短梭形的肿瘤细胞(苏木精-伊红 中倍放大);C:异型的肿瘤细胞及病理性核分裂像(箭头所示,苏木精-伊红 中倍放大);D:蕾丝样,花边样红染的骨样基质(红色箭头所示)及多核瘤巨细胞(黄色箭头所示)(苏木精-伊红 中倍放大);E:肿瘤内的肿瘤性成骨(苏木精-伊红 低倍放大);F:肿瘤细胞MDM2(+)(Envison法 低倍放大);G:肿瘤细胞CDK4(+)(Envison法 低倍放大);H:肿瘤细胞P53(+)(Envison法 低倍放大);I:肿瘤细胞Ki-67阳性指数40%(Envison法 低倍放大)
图2 病例2术前CT影像示肿物破坏下颌骨骨质,侵犯周围软组织
图3 病例3(右侧下颌骨骨肉瘤)CT影像及组织病理图片 A:CT示右侧下颌骨异常增粗;B:肿瘤中纤维性成分和不规则的骨性成分(苏木精-伊红 低倍放大);C:肿瘤中细胞丰富的纤维性成分,分化较好(苏木精-伊红 中倍放大);D:肿瘤中轻度异型的梭形细胞(苏木精-伊红 中倍放大);E:肿瘤中局部区域骨母细胞增多、异型,可见肿瘤性成骨(苏木精-伊红 中倍放大)
表1 颌骨骨肉瘤与良性骨病(纤维结构不良)免疫组化表达对比
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