成人孤立性骨嗜酸性肉芽肿45例临床分析
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利洪艺，温丽丽，王博，李洪波，王永谦，沈靖南，黄纲，谢显彪Vol.39(6):-
摘要：探讨成人孤立性骨嗜酸性肉芽肿（EG）的临床表现、影像与病理特点、治疗及预后。回顾性分析从年9月至年6月共45例成人孤立性骨EG患者的临床、影像学病理表现及治疗预后情况。男35例，女10例，中位年龄29岁，临床受累骨骼包括颅面骨（9例）、脊柱（11例）、肋骨（1例）、骨盆（8例）、锁骨（3例）、肩胛骨（2例）、肱骨（3例）及股骨（8例）等，平均随访81月。影像学特征为溶骨性破坏病灶，脊柱病灶中均未出现扁平椎改变，免疫组化多为CD1a、Langerin（CD）及S阳性。其中3例予保守观察，23例予手术治疗，8例接受小剂量化疗，其余11例行手术及术后辅助小剂量化疗，其中40例痊愈，5例复发后均再接受化疗，无进展生存时间（PFS）为3～个月，中位PFS为67个月。孤立性骨EG临床发病率很低，尤其成人更为罕见，临床表现无明显特异性，影像学表现易误诊，需重视病理检查，因成人孤立性骨EG的生物学行为比儿童更具侵袭性，治疗需个体化的同时可采取比儿童EG更积极的策略。
关键词： 嗜酸性肉芽肿；骨；成人；治疗；预后
Abstract：Toanalyzethefeaturesofclinical,radiology,pathology,treatmentandprognosisofsolitaryeosinophilicgranuloma(EG)bonelesionsinadults.Weretrospectivelyreviewedtherecordsof45adultpatientswithsolitaryEGbonelesionsatourinstitutions.Thefeaturesofclinical,radiology,pathology,treatmentandprognosiswereanalyzed.Therewere35malesand10females,themedianagewas29years,themeanfollow-uptimewas80.89month.ThedistributionoflesionssiteswereCraniofacialbone(9cases),spine(11cases),pelvis(8cases),clavicle(3cases),scapula(2cases),humerus(3cases),femur(8cases).Radiographicfindingswerecharacteristicallyosteolyticlesions,vertebraplanawasnotfoundin11spinalcases,immunohistochemistryshowedpositiveinCD1a,Langerin(CD)andS.Ofthe45adultcases,3casesreceivedobservation;surgerywasperformedin23cases,lowdosechemotherapyweregivenin8cases,andtherestof11caseswereadministeredsurgeryandadjuvantchemotherapy.Fortycaseswerehealed,while5casesdevelopedprogressorrelapseandreceivedchemotherapyagain,therangeofprogress-freesurvival(PFS)was3-months(median:67months).SolitaryEGbonelesionsarerare,particularlyinadults.Insidiousclinicalpresentationandaggressiveradiologyfeaturecouldeasilydevelopmisdiagnose,accordinglypathologyisvitalfordiagnosis.Individualizedmanagementandmoreactiveinterventionwerere头皮白癜风用什么药哪里能治好癜风
