口腔病理科 On-Line KMU Student Bulletin
- 1 -
原文題目(出處)： Benign fibrous histiocytoma in the condylar process of the mandible: Case report Br J Oral Maxillofac Surg 2008;46:e1-2
原文作者姓名： Katagiri W, Nakazawa M, Kishino M
通訊作者學校： Department of Oral and Maxillofacial Surgery II, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
Department of Oral Pathology, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
報告者姓名(組別)： 徐重興 Int B組
報告日期： 97.12.19
內文：
Benign fibrous histiocytoma
A mesenchymal tumor that occurs predominantly on the skin of extremities, as well as in
bone including femur, tibia, and ilium. However, it is rare in the jaw.
Case report
A 48-year-old man had a radiograph before a tooth extraction, and a unilocular radiolucent lesion with a partly irregular margin at the right condylar process was found (Fig. A). No symptoms had been noted before. Computed tomogram (CT) showed expansion of the condylar process and thinning
of the cortical bone (Fig. B) fluorodeoxyglucose positron tomograph (FDG-PET) showed no specific uptake in the body.
Operation
Cortical bone of condylar process was found to be perforated.The tumour was a single solid mass
14x11x8 mm with no fibrous
capsule. Histological examination of frozen sections showed proliferating histiocytic cells with no malignant findings. The tumour was composed of foamy histiocytic cells, spindle cells, and fibrous
口腔病理科 On-Line KMU Student Bulletin
- 2 -
tissue with hyalinization Discussion
Benign fibrous histiocytoma in the jawbone is uncommon and one has been recorded in the maxilla and four in the mandible, to our knowledge. Buccal swelling was the prominent sign in the mandible and a multilocular or soap-bubble-like radiolucent lesion involving the ramus. In contrast, our case had no symptoms and the tumour was identified incidentally from radiographs. However, as the lesion had an irregular margin, it was thought to be a metastatic or primary malignant lesion, and the finding of the FDG-PET and the frozen section diagnosis excluded malignancy.
Non-ossifying fibroma is an important tumour to be differentiated from ours, because it is indistinguishable histologically. In our case, proliferation of histiocytic cells, shown both histologically and immunohistochemically, was a predominant feature in differentiating the tumor from a non-ossifying fibroma. Radiographic examination showed no well-defined margin of the tumour, so we reached our diagnosis even though we did not see a typical striform pattern
with spindle cells. As no fibrous encapsulation was generated, complete removal of the tumour was essential to prevent recurrence. No recurrence has been found after a year, but a long-term follow-up is essential.
題號 題目
1 關於histiocytoma何者錯誤?
(A) 多發生在皮膚或四肢的長骨 (B) 很少發生在jaw bone
(C) 通常會有bone swelling (D) 不會發生在上顎
答案(D) 出處：benign fibrous histiocytoma in the condylar process of the mandible
題號 題目
2 Non-ossifying fibroma和histiocytoma的敘述何者正確?
(A) 兩者都常發生在長骨
(B) 前者多是fibrous tissue後者多是histiocytic cell (C) 以上皆是
(D) 以上皆非 答案(C) 出處：
