KOSTNAYa CYST aneurysmal

From Big Medical Encyclopedia

BONE CYST aneurysmal (synonym: subperiostal giant-cell tumor, atypical giant-cell tumor, hemorrhagic bone cyst, ossifying hematoma) — rather rare solitary pathological formation of a bone of the obscure etiology. For the first time aneurysmal To. to. Jaffe is described (H. L. Jaffe) and L. Likhtenstayn in 1942 and later is allocated in a separate nozol, a form. Most of researchers considers a disease of a consequence of an injury of a bone with subperiostal hemorrhage and the subsequent its ossification. Geshikter and Copeland (Page F. Geschickter, M. M. of Copeland) carry this nozoforma to atypical types of a giant-cell tumor (see. Osteoblastoclastoma ), proceeding from existence in fabrics of a cyst of multinuclear plasmocytes.

Anatomic substrate aneurysmal To. to. the fabric surrounded with a thin bone wall, located in a bone or supporting its limits is patol. On a section the cyst consists of substance of yellowish-brown and gray color. Histologically considerably vaskulyarizirovanny fabric is found fibrous. Vessels in a cyst are deprived of a muscular layer and elastic fabric, aneurysmally are expanded places and form cavernous cavities. Walls of these cavities are covered by the cells reminding an endothelium among which huge multinucleate cells occur. Are found as well the arteriovenous, partially obliterated anastomosis.

At an arrangement aneurysmal To. to. in a diaphysis, a tubular bone the periosteum which is pushed aside patol, fabric produces a thin bone cover around a cyst. In relation to a diaphysis the cyst is located usually excentricly. At localization in a metaphysis of tubular bones, and also in flat and spongy bones the cyst is located in the depth of a bone. In these cases the bast layer is thinned and blown up knaruzh.

Fig. Roentgenograms of a bone aneurysmal cyst: 1 — the distal metadiaphysis of a hip (in a direct projection) is poluveretenoobrazno blown up, the bast layer is sharply thinned; contours of the changed site of a bone accurate, structure its coarse; 2 — in a bast layer of a diaphysis of a femur (a side projection) the ovoidny education supporting limits of a bone in soft tissues from which the pathological center is delimited by a narrow calciphied border is defined (it is specified by an arrow).

Aneurysmal To. to. meets generally at young age. It is clinically shown by moderate pains in the field of its arrangement. At superficial localization it is probed as the limited education connected with a bone. Convincing proofs in favor of blastomatous character aneurysmal To. to. no. Current its high-quality. On roentgenograms it comes to light in the form of local swelling of a bone with thinning of a bast layer and a cellular structure. Bone crossbeams in a cyst give it looking alike a giant-cell tumor (fig., 1). At localization of a cyst in a diaphysis regional oval defect in a bone is observed, it is frequent with existence of thin bone partitions; from soft tissues the cyst is covered with a thin bone cover (fig., 2).

On materials E. I. Astakhova (1973), the angiographic picture of a cyst depends on its stage and biol, activities. At initial stages of development of a very techtonic dance of vessels can be usual, with weak contrasting of a cyst in a venous phase; with an active growth of a cyst its contrasting sharply amplifies. Unlike malignant tumors hyper vascularization on the periphery of a cyst is expressed poorly, expansion of the bringing arteries is insignificant.

Differential diagnosis on the basis of data of clinic, rentgenol. researches, an angiography and a biopsy it is carried out with a giant-cell tumor, hondroblastomy (see), Ewing's tumor (see. Ewing tumor ), chondroma (see) and hemangioma (see).

Treatment operational. Satisfactory results are yielded also by radiation therapy. Forecast favorable.

Bibliography: Astakhova E. I. Aneurysmal bone cyst, Vestn, rentgenol. and radio-gramophones., No. 3, page 38, 1973, bibliogr.; Kagan E. M and Klimova M. K. Aneurysmal cysts of bones, there she, No. 2, page 3, 1965, bibliogr.; P e y nb e r S. A. Radiodiagnosis of diseases of bones and joints, book 2, page 331, M., 1964; E dei k en J. a. H about d es P. J. Roentgen diagnosis of diseases of bone, v. i \22222222, Baltimore, 1973; G w i n n J. L. Aneurysmal bone cyst, Amer. J. Dis. Child., v. 130, p. 67, 1976; J a f f e H. L. a. Lichtenstein L. Solitary unicameral bone cyst, with emphasis on roentgen picture, pathologic appearance and pathogenesis, Arch. Surg., Y. 44, p. 1004, 1942.

S. A. Sviridov.