骨腫瘤分類課件

1、WHO ( 2013 ) 骨腫瘤分類,,軟骨源性腫瘤 ( Chondrogenic tumor ),良性 ( Benign )骨軟骨瘤 ( Osteochondroma )軟骨瘤 ( Chondroma )內(nèi)生軟骨瘤 ( Enchondroma )骨膜軟骨瘤 ( Periosteal chondroma )骨軟骨黏液瘤 ( Osteochondromyxoma ) ★甲下外生性骨疣 ( Subungual exostosis

2、 ) ★奇異性骨旁骨軟骨瘤樣增生 ( Bizarre parosteal osteochondromatous proliferation ) ★滑膜軟骨瘤病 ( Synovial chondromatosis ),,中間型 [ 局部侵襲性 ] ( Intermediate)軟骨黏液樣纖維瘤 ( Chondromyxiod fibroma )非典型軟骨樣腫瘤★ / 軟骨肉瘤 ( I 級(jí) ) ( Atypical cartilag

3、inous tumor / Chondrosarcoma, grade I )中間型 [ 偶見轉(zhuǎn)移型 ] ( Intermediate )軟骨母細(xì)胞瘤 ( Chondroblastoma ),,惡性 ( Malignant )軟骨肉瘤 ( II 級(jí)，III 級(jí) ) ( Chondrosarcoma, grade II, gradeIII )去分化軟骨肉瘤 ( Dedifferentiated chondrosarcoma )間

4、葉性軟骨肉瘤 ( Mesenchymal chondrosarcoma )透明細(xì)胞軟骨肉瘤 ( Clear cell chondrosarcoma ),骨源性腫瘤 ( Osteogenic tumor ),良性 ( Benign )骨瘤 ( Osteoma ) ★骨樣骨瘤 ( Osteoid osteoma )中間型 [ 局部侵襲性 ] ( Intermediate)骨母細(xì)胞瘤 ( Osteoblastoma ),,惡性 (

5、Malignant )低級(jí)別中心型骨肉瘤 ( Low-grade central osteosarcoma )普通型骨肉瘤 ( Conventional osteosarcoma )成軟骨型骨肉瘤 ( Chondroblastic osteosarcoma )成纖維型骨肉瘤 ( Fibroblastic osteosarcoma )成骨型骨肉瘤 ( Osteoblastic osteosarcoma )毛細(xì)血管擴(kuò)張型骨肉瘤

6、( Telangiectatic osteosarcoma )小細(xì)胞骨肉瘤 ( Small cell osteosarcoma )繼發(fā)性骨肉瘤 ( Secondary osteosarcoma )骨旁骨肉瘤 ( Parosteal osteosarcoma )骨膜骨肉瘤 ( Periosteal osteosarcoma )高級(jí)別表面骨肉瘤 ( High-grade surface osteosarcoma ),纖維源性腫瘤

7、( Fibrogenic tumor ),中間型 [ 局部侵襲性 ] ( Intermediate)( 骨的 ) 促結(jié)締組織增生性纖維瘤 ( Desmoplastic fibroma of bone )惡性 ( Malignant )( 骨的 ) 纖維肉瘤 ( Fibrosarcoma of bone ),纖維組織細(xì)胞性腫瘤 ( Fibrohistiocytic Neoplasm ),良性纖維組織細(xì)胞瘤/非骨化性纖維瘤 ★ ( B

8、enign fibrous histocytoma/Non-ossifying fibroma ),造血系統(tǒng)腫瘤 ( Haematopoietic neoplasm ),惡性 ( Malignant )漿細(xì)胞骨髓瘤 ( Plasma cell myeloma )( 骨的 ) 孤立性漿細(xì)胞瘤 ( Solitary plasmacytoma of bone )( 骨的 ) 原發(fā)性非霍奇金淋巴瘤 ( Primary non-Ho

9、dgkin lymphoma of bone ),富于巨細(xì)胞的破骨細(xì)胞腫瘤 ( Osteoclastic giant cell-rich tumor ),良性 ( Benign )小骨的巨細(xì)胞病變 ( Giant cell lesion of the small bones ) ★中間型 [ 局部侵襲性，偶見轉(zhuǎn)移型 ] ( 骨的 ) 巨細(xì)胞腫瘤 ( Giant cell tumor of bone )惡性 ( Malign

10、ant )骨巨細(xì)胞瘤內(nèi)的惡性 ( Malignancy in giant cell tumor of bone ),脊索樣腫瘤 ( Notochordal tumor ),良性 ( Benign )良性脊索樣細(xì)胞瘤 ( Benign notochordal cell tumor ) ★惡性 ( Malignant )脊索瘤 ( Chordoma ),血管性腫瘤 ( Vascular tumor ),良性 ( Benign )血

11、管瘤 ( Haemangioma )中間型 [ 局部侵襲性，偶見轉(zhuǎn)移型 ] 上皮樣血管瘤 ( Epithelioid haemangioma ) ★惡性 ( Malignant )上皮樣血管內(nèi)皮瘤 ( Epithelioid haemangioendothelioma ) ★血管肉瘤 ( Angiosarcoma ),肌源性腫瘤 ( Myogenic tumor ),良性 ( Benign )( 骨的 ) 平滑肌瘤 ( L

12、eiomyoma of bone )惡性 ( Malignant )( 骨的 ) 平滑肌肉瘤 ( Leiomyosarcoma of bone ),脂肪源性腫瘤 ( Lipogenic tumor ),( 骨的 ) 脂肪瘤 ( Lipoma of bone )( 骨的 ) 脂肪肉瘤 ( Liposarcoma of bone ),未明確腫瘤性質(zhì)的腫瘤 ( Tumor of undefined neoplastic ature )

13、,良性 ( Benign )單純性骨囊腫 ( Simple bone cyst )纖維結(jié)構(gòu)不良 [ 纖維異常增殖癥 ] ( Fibrous dysplasia )骨性纖維結(jié)構(gòu)不良 ( Osteofibrous dysplasia )軟骨間葉性錯(cuò)構(gòu)瘤 ( Chondromesenchymal hamartoma )Rosai-Dorfman病 ( Rosai-Dorfman disease ),,中間型 [ 局部侵襲性 ] 動(dòng)

14、脈瘤樣骨囊腫 ( Aneurysmal bone cyst )朗格漢斯細(xì)胞組織細(xì)胞增多癥 ( Langerhans cell histiocytosis) 單骨型 ( Monostotic ) 多骨型 ( Polystotic )Erdheim-Chester病 ( Erdheim-Chester disease ),雜類腫瘤 ( Miscellaneous tumor ),尤文肉瘤 (

15、Ewing sarcoma )釉質(zhì)瘤 ( Adamantinoma )( 骨的 ) 未分化高級(jí)別多形性肉瘤 ( Undifferentiated highgrade pleomorphic sarcoma of bone ),附：腫瘤綜合征 ( Tumor syndromes ),Bechwith-Wiedemann 綜合征 ( Bechwith-Wiedemann syndrome )家族性巨頜癥 ( Cherubism )

16、★內(nèi)生軟骨瘤?。篛llier 病和 Maffucci 綜合征 ( Enchondromatosis:Ollier disease and Maffucci syndrome )Li-Fraumeni 綜合征 ( Li-Fraumeni syndrome ) ★McCune-Albright 綜合征 ( McCune-Albright syndrome )多發(fā)性骨軟骨瘤 ( Multiple osteochondroma )神經(jīng)

17、纖維瘤病 1 型 ( Neurofibromatosis, type 1 )視網(wǎng)膜母細(xì)胞瘤綜合征 ( Retinoblastoma syndrome )Rothmund-Thomson 綜合征 ( Rothmund-Thomson syndrome)Werner 綜合征 ( Werner syndrome ),,Bechwith-Wiedemann：沒有命中的記錄!Ollier病是一種多發(fā)性軟骨瘤，病變廣泛，并有單側(cè)肢體受累現(xiàn)象

18、，因此骨骼的彎曲，短縮等畸形更為常見。Maffucci是一種以多發(fā)性內(nèi)生軟骨瘤合并血管瘤為特征的病變。Li-Fraumeni綜合征患者遺傳有抑癌基因P53一個(gè)缺陷的等位基因，他們有很高的乳腺癌及其他惡性腫瘤的發(fā)病率,30歲時(shí)達(dá)50%,70 歲可高達(dá)90%。McCune-Albright是一種較少見的伴有皮膚斑片狀色素沉著和多發(fā)性囊性纖維性骨發(fā)育不良的先天性內(nèi)分泌障礙臨床綜合征，屬鳥核苷酸結(jié)合蛋白病(G蛋白病)。,,神經(jīng)纖維瘤?。荷?/p>

19、經(jīng)皮膚綜合征發(fā)生在胚胎2-4月神經(jīng)元增殖、組織發(fā)生和分化階段，主要累及皮膚、周圍神經(jīng)和中樞神經(jīng)系統(tǒng)。N1患者的顱內(nèi)新生物來(lái)自于中樞神經(jīng)系統(tǒng)的主要組成成分，如星型細(xì)胞和神經(jīng)元；N2患者的顱內(nèi)新生物來(lái)自于中樞神經(jīng)系統(tǒng)的覆蓋物，如腦膜和雪旺氏細(xì)胞。視網(wǎng)膜母細(xì)胞瘤綜合征 ：？13號(hào)染色體長(zhǎng)臂缺失綜合征可有多種異常表型。Rothmund-Thomson：(即先天性皮膚異色癥)是一種較少見的常染色體隱性遺傳性疾病。33％的患者發(fā)生骨骼形成障礙