软骨肉瘤.pptVIP

Chondrosarcoma 软骨肉瘤 胸组病例讨论 09.11.10 Introduction Chondrosarcomas are malignant neoplasms populated by mesenchymal cells that produce a cartilaginous matrix. 3.5% of all primary bone tumors and 20%-27% of primary malignant osseous neoplasms, exceeded in frequency only by multiple myeloma and osteosarcoma. Most patients are in the 40-60 year range with a 2:1 male predilection Introduction The bones of the shoulder, pelvis, proximal femur and ribs are most commonly involved In contrast to enchondroma, chondrosarcoma rarely involves the distal extremities Introduction Categories of primary chondrosarcomas have been described, including： conventional intramedullary（普通髓内型）, juxtacortical（皮质旁型）, extraskeletal（骨外型）, clear cell（透明细胞型）, myxoid（粘液型）, mesenchymal（间质型）and dedifferentiated（去分化型）. Introduction Chondrosarcomas present most often as enlarging, painful masses; their growth rate and ultimate behavior is closely correlated with histologic grade. Chondrosarcomas metastasize via the hematogenous route, most often to the lungs. 5-year survival rate was 90%, 81% and 43% in grades 1 through 3 in one study. Conclusions Although the pathologic appearance varies with speci?c lesion type, chondrosarcomas grow with lobular type architecture, and these hyaline cartilage nodules demonstrate high water content and peripheral enchondral ossi?cation. * 脊索瘤(Chordoma) Notochord Other 骨巨细胞瘤（Giant cell tumor of bone） Myeloid 成软骨细胞瘤（Chondroblastoma） Chondroblast Epiphysis 骨化纤维瘤（Ossifying fibroma） 纤维肉瘤（Fibrosarcoma） Fibrous 软骨瘤 软骨肉瘤（Chondrosarcoma） 骨软骨瘤 软骨粘液样纤维瘤 Chondroblast 骨样骨瘤 成骨细胞瘤（Osteoblastoma） 骨瘤（Osteoma） 骨肉瘤（Osteosarcoma） Osteoblast Metaphysis Ewing’s sarcoma PNET 釉质细胞瘤（Adamantinoma） Epithelial 多发性骨髓瘤（Multiple myeloma） Myeloid Diaphysis SITE OF LONG BONE INVOLVEMENT (most primary bone tumors have favored sites within long bones; this may provide a clue to diagnosis).  Diaphyseal intramedullary lesions:Favored location for Ewings sarcoma, lymphoma, myel