Clinical And Imaginganalysis Of Benign Fibrous Histiocytoma Of Bone

Objective：Benign fibrous histiocytoma of bone is a rare kind of tumor in skeletalmuscular system. The morbidity is only about1%and the canceration rate is very low.It’s part of the tissue cell tumor in the WHO classification. It can be easily recrudesceafter surgery if we fail to recognize the distinguishing feature. We make a furtherdiscussion by combining our cases with the literature and focusing on the clinical andiconography characteristics to improve our diagnosis and treatment ability. Besides，toreduce the agony and financial burden of patients.Methords： We make a review of the cases during2010to2012in General Hospital ofBeijing Military Region. Consult every case history and imaging data according toname， admission number， name of the disease of something like that and make aclassification. We finally find four cases， which underwent X-ray examination.（Siemens Opti150HC-100and Philips OPTIMU S DR set，front and lateral position），CT（CE HD750America）and MRI（GE Signa1.5T ExciteⅡ，GE Sig naEXCITEHD1.5Tand3.0TMRI set，The main sequence is SE T1W(TR500ms，TE14ms)， SET2W(TR4000ms，TE80ms)and gtadient echo (GRE：TR150ms，TE4.72ms，FA70o).One of these patient undertake radionuclide scan because of Postoperative examinationof right breast cancer radical operation. We make a biopsy and the result proved to beBFH.Results：In these four cases，the age rages from37to84, and the average age is55.25.3of whom are female and the other is male. The medical histories are all more than1year，in which the longest lasts seven years and1month. The clinical symptom is mildin three of them.Most of them are aware of the intermittent pain while without night pain or limitation of activity. One of them refers to limitations of the pain only for onemonth before admission. One of them is aware of the disease just because ofradioisotope scanning after mammary cancer surgery. The rest two patients seekmedical advice because of painless mass.All of them are of single lesion，including aexpansive growth case. In this case， the boundary is clear， the cortex of bone is thinand we can see the cortical bone around the hardening.There is no evidence ofperiosteal reaction and soft tissue mass. In another case, osteolytic change accuredin the local lesion. Inhomogeneous low density shadow and periosteal reaction appearedbased on the points mentioned above. CT result:The lesion showed osteolytic damage，internal non-uniform， showed expansive growth， lesions with clear edge， bonesclerosis， cortical thinning， rugged， interrupt， micro fracture， outward to thecladding is prominent， but no breakthrough， no obvious soft tissue mass， and noperiosteal reaction.MRI result： The lesion is cystic change， clear boundaries，separated in a linear enhancement，the medullary cavity irregular soft tissue mass， along T1and long T2signal， signal under uniform， visible point sheet short T1andlong T2signal intralesional hemorrhage， patchy long T1and long T2signal on softtissue necrosis， normal.Conclusion： Clinical features of benign fibrous histiocytoma of the bone： Clinicalsymptoms of most patients is mild or not obvious， most of onset process is slow. afterthe discovery of local soft tissue mass or painless nature hard lump or pathologicfracture， the patient will go to hospital for a visit. Generally no accompany ofassociated with adjacent joint involvement， and rarely systemic symptoms. Imagingfindings： X-ray manifestations usually expansive growth， well-defined osteolyticbone destruction，bony shell，without any particularity of the typical imaging findings.But are still different from giant cell tumor of osteolytic tumor. Usually because lack oftypical leisions， we need different imaging examinations to distinguish. Then we couldobserve the disease omnibearingly and reach to a more profound understanding.