Osteosarcoma-A Morphological Study of Eighty-three Cases

骨肉瘤－八十三例之病理形態學研究

李正華(Janq-Hwa Lee) ； 杜炎昌(Yen-Cheng Tu)

《Journal of Medical Sciences》 4卷4期 (1982/07) Pp. 1417-1423

摘要

以八十三例骨肉瘤探討其形態，流行病學及臨床上之關係。有百分之七十二點三的病例為二十五歲以下的年輕人，而犯的部位多在膝關節兩側的骨頭，約佔百分之五十九。顯微鏡下，我們依主要的腫瘤成份于以次分類如下：百分之四十二點一為骨芽性型，百分之二十一點八為軟骨芽性型，百分之三十六點一為纖維芽性型。不過這種次分類和骨肉瘤的預後之間的關係，無法在此肯定的闡明。一種新的骨腫瘤－惡性纖維性組織細胞瘤－在此特地提出討論，並且在這篇回溯性的研究裡，我們也找出兩例過去診斷為骨肉瘤的，現在應重新加以分類。一些診斷上的困難，尤其是臨床上的及X光片之資料闕如的情況下，如骨痂，轉移癌等，也在此加以研討。

並列摘要

83 cases of osteosarcoma are reported. Comparative epidemiological, clinical, and pathological studies have been carried out. We found that of 72.3% osteosarcoma occurred in patients under 25 years of age. The most frequent site for this tumor is the bones near a knee joint (59%). Microscopically, we subclassified osteosarcoma into 3 types: osteoblastic (42.1%), chondroblastic (21.8), and fibro-blastic (36.1%). But the correlation between this subclassification and prognosis of osteosarcoma cannot be assured. The new entity of primary fibrous histocytoma of bone is stressed here and two cases previously diagnosed as osteosarcoma are reviewed in this retrospective study. Some difficulties in differentiating primary malignant fibrous histocytoma from osteosarcoma as well as the differential diagnosis of some entities, such as callus or metastatic anaplastic carcinoma, without full comprehension of the clinical and radiologic clues of the biologic behavior of the tumor are also discussed.