WHO(2013)骨腫瘤分類課件

WHO(2013)骨腫瘤分類

WHO(2013)骨腫瘤分類軟骨源性腫瘤(Chondrogenictumor)良性(Benign)骨軟骨瘤(Osteochondroma)軟骨瘤(Chondroma)內(nèi)生軟骨瘤(Enchondroma)骨膜軟骨瘤(Periostealchondroma)骨軟骨黏液瘤(Osteochondromyxoma)★甲下外生性骨疣(Subungualexostosis)★奇異性骨旁骨軟骨瘤樣增生(Bizarreparostealosteochondromatousproliferation)★滑膜軟骨瘤病(Synovialchondromatosis)WHO(2013)骨腫瘤分類中間型[局部侵襲性](Intermediate)軟骨黏液樣纖維瘤(Chondromyxiodfibroma)非典型軟骨樣腫瘤★/軟骨肉瘤(I級(jí))(Atypicalcartilaginoustumor/Chondrosarcoma,gradeI)中間型[偶見(jiàn)轉(zhuǎn)移型](Intermediate)軟骨母細(xì)胞瘤(Chondroblastoma)WHO(2013)骨腫瘤分類惡性(Malignant)軟骨肉瘤(II級(jí)，III級(jí))(Chondrosarcoma,gradeII,gradeIII)去分化軟骨肉瘤(Dedifferentiatedchondrosarcoma)間葉性軟骨肉瘤(Mesenchymalchondrosarcoma)透明細(xì)胞軟骨肉瘤(Clearcellchondrosarcoma)WHO(2013)骨腫瘤分類骨源性腫瘤(Osteogenictumor)

良性(Benign)骨瘤(Osteoma)★骨樣骨瘤(Osteoidosteoma)中間型[局部侵襲性](Intermediate)骨母細(xì)胞瘤(Osteoblastoma)WHO(2013)骨腫瘤分類惡性(Malignant)低級(jí)別中心型骨肉瘤(Low-gradecentralosteosarcoma)普通型骨肉瘤(Conventionalosteosarcoma)成軟骨型骨肉瘤(Chondroblasticosteosarcoma)成纖維型骨肉瘤(Fibroblasticosteosarcoma)成骨型骨肉瘤(Osteoblasticosteosarcoma)毛細(xì)血管擴(kuò)張型骨肉瘤(Telangiectaticosteosarcoma)小細(xì)胞骨肉瘤(Smallcellosteosarcoma)繼發(fā)性骨肉瘤(Secondaryosteosarcoma)骨旁骨肉瘤(Parostealosteosarcoma)骨膜骨肉瘤(Periostealosteosarcoma)高級(jí)別表面骨肉瘤(High-gradesurfaceosteosarcoma)WHO(2013)骨腫瘤分類纖維源性腫瘤(Fibrogenictumor)

中間型[局部侵襲性](Intermediate)(骨的)促結(jié)締組織增生性纖維瘤(Desmoplasticfibromaofbone)惡性(Malignant)(骨的)纖維肉瘤(Fibrosarcomaofbone)WHO(2013)骨腫瘤分類纖維組織細(xì)胞性腫瘤(FibrohistiocyticNeoplasm)

良性纖維組織細(xì)胞瘤/非骨化性纖維瘤★(Benignfibroushistocytoma/Non-ossifyingfibroma)WHO(2013)骨腫瘤分類造血系統(tǒng)腫瘤

(Haematopoieticneoplasm)

惡性(Malignant)漿細(xì)胞骨髓瘤(Plasmacellmyeloma)(骨的)孤立性漿細(xì)胞瘤(Solitaryplasmacytomaofbone)(骨的)原發(fā)性非霍奇金淋巴瘤

(Primarynon-Hodgkinlymphomaofbone)WHO(2013)骨腫瘤分類富于巨細(xì)胞的破骨細(xì)胞腫瘤(Osteoclasticgiantcell-richtumor)

良性(Benign)小骨的巨細(xì)胞病變(Giantcelllesionofthesmallbones)★中間型[局部侵襲性，偶見(jiàn)轉(zhuǎn)移型]

(骨的)巨細(xì)胞腫瘤(Giantcelltumorofbone)惡性(Malignant)骨巨細(xì)胞瘤內(nèi)的惡性(Malignancyingiantcelltumorofbone)WHO(2013)骨腫瘤分類脊索樣腫瘤(Notochordaltumor)

良性(Benign)良性脊索樣細(xì)胞瘤(Benignnotochordalcelltumor)★惡性(Malignant)脊索瘤(Chordoma)WHO(2013)骨腫瘤分類血管性腫瘤(Vasculartumor)

良性(Benign)血管瘤(Haemangioma)中間型[局部侵襲性，偶見(jiàn)轉(zhuǎn)移型]上皮樣血管瘤(Epithelioidhaemangioma)★惡性(Malignant)上皮樣血管內(nèi)皮瘤(Epithelioidhaemangioendothelioma)★血管肉瘤(Angiosarcoma)WHO(2013)骨腫瘤分類肌源性腫瘤(Myogenictumor)

良性(Benign)(骨的)平滑肌瘤(Leiomyomaofbone)惡性(Malignant)(骨的)平滑肌肉瘤(Leiomyosarcomaofbone)WHO(2013)骨腫瘤分類脂肪源性腫瘤(Lipogenictumor)(骨的)脂肪瘤(Lipomaofbone)(骨的)脂肪肉瘤(Liposarcomaofbone)WHO(2013)骨腫瘤分類未明確腫瘤性質(zhì)的腫瘤

(Tumorofundefinedneoplasticature)

良性(Benign)單純性骨囊腫(Simplebonecyst)纖維結(jié)構(gòu)不良[纖維異常增殖癥](Fibrousdysplasia)骨性纖維結(jié)構(gòu)不良(Osteofibrousdysplasia)軟骨間葉性錯(cuò)構(gòu)瘤(Chondromesenchymalhamartoma)Rosai-Dorfman病(Rosai-Dorfmandisease)WHO(2013)骨腫瘤分類中間型[局部侵襲性]

動(dòng)脈瘤樣骨囊腫(Aneurysmalbonecyst)朗格漢斯細(xì)胞組織細(xì)胞增多癥(Langerhanscellhistiocytosis)

單骨型(Monostotic)

多骨型(Polystotic)Erdheim-Chester病(Erdheim-Chesterdisease)WHO(2013)骨腫瘤分類雜類腫瘤(Miscellaneoustumor)

尤文肉瘤(Ewingsarcoma)釉質(zhì)瘤(Adamantinoma)(骨的)未分化高級(jí)別多形性肉瘤(Undifferentiatedhighgradepleomorphicsarcomaofbone)WHO(2013)骨腫瘤分類附：腫瘤綜合征

(Tumorsyndromes)

Bechwith-Wiedemann綜合征(Bechwith-Wiedemannsyndrome)家族性巨頜癥(Cherubism)★內(nèi)生軟骨瘤?。篛llier病和Maffucci綜合征(Enchondromatosis:OllierdiseaseandMaffuccisyndrome)Li-Fraumeni綜合征(Li-Fraumenisyndrome)★McCune-Albright綜合征(McCune-Albrightsyndrome)多發(fā)性骨軟骨瘤(Multipleosteochondroma)神經(jīng)纖維瘤病1型(Neurofibromatosis,type1)視網(wǎng)膜母細(xì)胞瘤綜合征(Retinoblastomasyndrome)Rothmund-Thomson綜合征(Rothmund-Thomsonsyndrome)Werner綜合征(Wernersyndrome)WHO(2013)骨腫瘤分類Bechwith-Wiedemann：沒(méi)有命中的記錄!Ollier病是一種多發(fā)性軟骨瘤，病變廣泛，并有單側(cè)肢體受累現(xiàn)象，因此骨骼的彎曲，短縮等畸形更為常見(jiàn)。Maffucci是一種以多發(fā)性內(nèi)生軟骨瘤合并血管瘤為特征的病變。Li-Fraumeni綜合征患者遺傳有抑癌基因P53一個(gè)缺陷的等位基因，他們有很高的乳腺癌及其他惡性腫瘤的發(fā)病率,30歲時(shí)達(dá)50%,70歲可高達(dá)90%。McCune-Albright是一種較少見(jiàn)的伴有皮膚斑片狀色素沉著和多發(fā)性囊性纖維性骨發(fā)育不良的先天性內(nèi)分泌障礙臨床綜合征，屬鳥(niǎo)核苷酸結(jié)合蛋白病(G蛋白病)。WHO(2013)骨腫瘤分類神經(jīng)纖維瘤病：神經(jīng)皮膚綜合征發(fā)生在胚胎2-4月神經(jīng)元增殖、組織發(fā)生和分化階段，主要累及皮膚、周圍神經(jīng)和中樞神經(jīng)系統(tǒng)。N1患者的顱內(nèi)新生物來(lái)自于中樞神經(jīng)系統(tǒng)的主要組成成分，如星型細(xì)胞和神經(jīng)元；N2患者