骨化纤维瘤和非骨化纤维瘤的比较

骨化纤维瘤，ossifying fibroma，是指骨的纤维结构（纤维性和骨样物质组成）出现异常改变，骨化指纤维组织间有大量纤细的条状新生骨，骨小梁周围有较多活跃的骨母细胞。常见于青少年(小于10岁)，女性多于男性，多为单发病灶。常见于下肢长骨（胫骨多见，腓骨少见），其次是颌骨（下颌骨多见）。

What do the terms “ossifying” and “fibroma” mean?

You may better understand this condition when you break down the definitions of each word.

• Ossifying is the medical term for changing into bone. With ossifying fibroma, bone develops within fibrous connective tissue where it doesn’t belong.

• Fibroma refers to the fibrous tissue that makes up the tumor. Healthcare providers use the suffix “-oma” to refer to all tumors, regardless of whether they’re cancerous (malignant).

  骨化性纤维瘤属于良性骨肿瘤，生长缓慢，早期无症状，随着病情发展，可有颌骨畸形，并累及上颌窦及邻近组织；发生在胫腓骨，可有弯曲表现。

CEMENTO OSSIFYING FIBROMA

骨化纤维瘤多为实性，囊性少见，镜下见大量的、排列成束和漩涡状的纤维组织，其中含有一些大小不等、排列不规则的骨小梁和钙化灶，骨小梁周围有少数成骨细胞，并含有骨样组织。通俗地讲，

X线检查，病变发生于骨干或近干骺端一侧皮质骨内，不累及骨骺，病灶呈偏心性膨胀性改变，多为不规则的单囊或多囊形，轮廓清晰，边缘硬化，病变一般不穿破骨皮质，无骨膜反应。晚期肿瘤组织逐渐骨化而密度增高，病灶内无钙化。病变范围广泛，骨骼可有畸形。

CT检查，骨皮质内囊状低密度影，其间常有增生骨化高密度影，骨皮质不规则增厚，可向髓腔内突出，导致髓腔变形、变小，甚至闭塞。

MRI检查，多数病灶在T1低信号，T2低信号。

病理检查，病变组织灰白色，有砂砾感。镜下病变由纤维组织和骨小梁构成。纤维母细胞和纤维细胞呈无定形排列，骨小梁形状不规则，周围被成排的骨母细胞包绕，偶尔可见破骨细胞，肿瘤的中央部常见编织骨，其外周逐渐向板状骨过度。

An ossifying fibroma is a rare noncancerous (benign) tumor that mostly affects your jawbones. It causes a tumor made of bone-like substances to form within connective tissue. These tumors don’t always cause symptoms, but treatment is a must. They can destroy healthy bone and cause dental problems. You’ll need oral surgery to remove the tumor.

An ossifying fibroma lesions like ossifying fibromas occur when fibrous tissue that contains a bone-like substance replaces healthy bone.

Ossifying fibromas are benign bone lesions that should be differentiated from non-ossifying fibromas and fibrous dysplasia. Osteofibrous dysplasia is considered as a separate pathological entity in view of its different presentation and treatment, although histopathologically similar to ossifying fibroma.

鉴别诊断

骨纤维异常增殖症，病变在骨髓腔内，中心性膨胀，边界不清，X线表现为磨砂玻璃样改变。骨小梁仅成熟到编织骨阶段，见不到板状骨，未成熟的骨小梁周围是纤维组织，无骨母细胞覆盖。

骨巨细胞瘤，病变位于骨骺线闭合处，病灶内无骨化影。

骨母细胞瘤，病变位于骺端呈小圆形低密度阴影，边界清楚，周围有反应骨形成硬化缘，病灶内可见点状钙化。

非骨化性纤维瘤，non-ossifying fibroma，由组织成纤维细胞组成的干骺端错构瘤，病变扩展侵入髓腔而且常合并病理性骨折。非骨化性纤维瘤最常见于儿童及青少年。非骨化性纤维瘤典型的X线特征，始于长骨的干骺端，靠近骺板，在一侧皮质上膨胀、偏心性，随骨的生长发育病变可以逐渐向骨干移行，病灶内为界限清楚透亮阴影，呈分叶状卵圆形，周边有一硬化缘。病变纵轴与长骨一致。

Non-ossifying fibromas are the most common benign bone tumor in children, affecting up to 40%. They are made of fibrous tissue and grow on long bones, especially the legs. They usually appear as a solitary growth. They don’t spread or turn to cancer. Non-ossifying fibromas go away on their own when the child has fully grown.

 “Fibroma” means fibrous (fibr) tumor (oma). “Non-ossifying” means that the tumor doesn’t calcify into bone tissue. The fibroma grows on bones, but it is not made of bone, as some others are.

On an X-ray, a non-ossifying fibroma is a dark mass with a white edge. Under the naked eye, it is yellow or tan in color and appears fleshy and fibrous, like scar tissue. It’s usually between 3 and 7 centimeters in size.