Histiocytic fibroma

Introduction to histiocytic fibroma Histiocytic fibroids are dry parasitic hamartomas composed of tissue fibroblasts. Currently, small, no clinical symptoms, lesions are confined to the subperiosteal or cortical, called metaphyseal fibrous defects, and the lesions are Larger, lesions can be invaded into the medullary cavity and often associated with pathological fractures called non-ossifying fibroids. basic knowledge The proportion of sickness: 0.0023% Susceptible people: no specific population Mode of infection: non-infectious Complications: fracture

The cause of histiocytoma

Cause:

It is a metaphyseal hamartoma composed of tissue fibroblasts.

(two) pathogenesis

The macroscopic lesions are elliptical in shape and vary in size. The texture of the section is yellow or rust brown, contains no bone tissue, and has a thin bone hardening zone around the tumor.

The tissue morphology is mainly composed of fibrous connective tissue, arranged in a spiral or spoke shape, with collagen fibers between the cells, and different numbers of collagen fibers and fibroblasts in different lesion areas. This fusiform fibroblast is called Facultative fibroblasts, scattered or piled of multinucleated giant cells in the lesion, small in size, the nucleus is generally 3 to 10, also visible phagocytic lipids and hemosiderin-containing tissue cells, namely foam cells, when a large amount of foam When cells exist, they phagocytose a large number of pigments, and the specimens are rust brown. They are easily misdiagnosed as yellow tumors. In addition, lymphocytes and plasma cells are scattered between tissues. There is no new bone formation in the lesions, and reactive bone sclerosis is seen in the periphery.

Tissue cell fibroma prevention

There is no effective preventive measure for this disease. Early detection and early diagnosis are the key to the prevention and treatment of this disease.

Tissue cell fibroma complications Complications

Can be associated with rational fractures.

Histopathic fibroma symptoms Common symptoms Joint pain, coffee plaque, vascular malformation

Histiocytoma is most common in children and adolescents. It is most common in 5 to 20 years old. Schajowicz reported ages ranging from 7 months to 69 years. There is no significant difference between men and women. It is reported that men are more than women.

The most common limbs are the long bones of the lower limbs, mainly located around the knee joint. The distal femoral metaphysis is the most common, followed by the proximal and distal metaphysis, and the proximal metaphysis of the humerus is also common. The proximal femoral metaphysis and upper limb bone, single-body tissue fibroids are very rare in short bones and flat bones.

Histiocytic fibroma can also have multiple lesions, which can occur in different parts of the same bone, or in different bones. This is called multiple histiocytoma, and its age of onset is similar to that of single hair. The most common lesions are the most common. In a single lower limb or both lower limbs, the pelvic bone can be involved at the same time.

Most of the lesions are at the metaphysis, and the disease can develop with the disease. The lesions can gradually migrate to the backbone, mostly in the one side of the cortex or under the periosteum. The lesion can be further developed to invade the medullary cavity and cause lesions in the entire metaphysis or diaphysis.

There are no clinical symptoms of histiocytoma, and even mild pain is the main manifestation. Foreign literature reports that 50% of patients with pain in the first diagnosis, 16% with pathological fractures, and 32% with accidental X-ray films.

Multiple tissue cell fibroids may be associated with milk coffee spots, mental retardation, gonad dysfunction, congenital abnormalities or vascular malformations of the eye, and no multiple neurofibromatosis syndrome, a syndrome known as Jaffe-Campanacci syndrome.

Examination of histiocytoma

Histiocytic fibroma has typical X-ray features. Some scholars believe that it is possible to make a correct diagnosis of most cases without histological examination. The lesion begins at the metaphysis of the long bone, close to the tarsal plate, and always in one side of the cortex. Upper, dilatation, eccentricity, with the growth and development of the bone can gradually migrate to the backbone, the lesion is clearly clear and transparent, with lobulated, oval, surrounded by a hardening margin, the longitudinal axis of the lesion is consistent with the long bone, and the lesion is small From 1cm, up to 15cm, the lesion develops into the medullary cavity, destroying the entire metaphysis, leading to thinning of the entire cortex, resulting in pathological fractures, lesions can be expanded with the growth of the tarsal plate, and the lesion may stop growing after sputum closure.

Multiple imaging of cell fibroma has a typical characteristic. It can have multiple lesions in the same bone, or it may not be in the same bone. The lesions are not continuous. Single lesions are similar to single hair, and multiple manifestations invade the medullary cavity. At the beginning of the metaphysis, further development of the transition to the backbone, lesions often exist symmetrically, this situation is more common in the upper limbs, tissue cell fibroids cause fractures are more common in lower limb lesions.

Diagnosis and diagnosis of histiocytoma

diagnosis

Most of the cases were diagnosed due to lesions found in X-ray films of the trauma. Tissue fibroids are asymptomatic and do not require surgical treatment. Due to the typical features of imaging, the diagnosis is more reliable.

Children, adolescents with knee, ankle or hip pain, images showing histiocytoma, often misdiagnosed as other tumors, and undergoing surgery, most tissue cell fibroids are usually asymptomatic.

When tissue fibromatosis lesions invade most or the entire metaphysis or backbone, imaging is not easy to diagnose, and some lesions are easily confused with fibrous structures, cartilage myxofibrosis, and bone cysts, often requiring surgical diagnosis.

Differential diagnosis

In cases of multiple lesions, the imaging features may be confused with fibrosis, and histologically, the tissue fibroids and fibrosis are consistent in certain lesion areas, which can be distinguished by the absence of new bone from histiocytic fibroids.

Histologically, it is necessary to exclude differentiated fibrosarcoma, giant cell tumor of bone, and differentiated from benign fibrous histiocytoma. From the histological point of view, it is considered that these two histological findings are completely identical, but benign fibrous tissue cells Tumors are more common in adults, and the age of onset is too large. In addition to the bones of the extremities, they can also be seen in flat bones. The imaging hardening of the surrounding cells is more obvious in terms of histiocytic fibroids.

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