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쇄골에 발생한 개화성 반응성 골막염: 증례 보고

Florid Reactive Periostitis of the Clavicle: A Case Report

  • 박혜은 (서울대학교 의과대학 병리과) ;
  • 채지원 (서울대학교 의과대학 영상의학과) ;
  • 조현철 (서울대학교 의과대학 정형외과) ;
  • 김지은 (서울대학교 의과대학 병리과) ;
  • 김동현 (서울대학교 의과대학 영상의학과) ;
  • 김효진 (서울대학교 의과대학 영상의학과) ;
  • 서지운 (서울대학교 의과대학 영상의학과)
  • Hye Eun Park (Department of Pathology, Seoul National University College of Medicine) ;
  • Jee Won Chai (Department of Radiology, Seoul National University College of Medicine) ;
  • Chris Hyunchul Jo (Department of Orthopedic Surgery, Seoul National University College of Medicine) ;
  • Ji Eun Kim (Department of Pathology, Seoul National University College of Medicine) ;
  • Dong Hyun Kim (Department of Radiology, Seoul National University College of Medicine) ;
  • Hyo Jin Kim (Department of Radiology, Seoul National University College of Medicine) ;
  • Jiwoon Seo (Department of Radiology, Seoul National University College of Medicine)
  • 투고 : 2021.06.11
  • 심사 : 2021.10.18
  • 발행 : 2022.03.01

초록

개화성 반응성 골막염은 드문 양성 섬유골성 증식으로 대부분 손의 짧은 관상골을 침범하고, 긴 관상골의 침범은 드물다. 저자들은 26세 남자에서 수술로 확진되었던 쇄골의 개화성 반응성 골막염 1예를 보고한다. 자기공명영상에서 병변은 높은 T2 신호강도를 보이는 연조직 종괴로 쇄골의 골막에서 기인하는 것으로 보였고, 주변의 골막거상과 종괴 주변의 연조직 부종이 관찰되었다. 조영증강 시 종괴의 내부는 강한 조영증강을 보였고, 쇄골의 골막을 따라서도 쇄골 둘레의 절반 이상을 둘러싸며 조영증강이 확인되었다. 연속된 단순촬영에서는 무기질 침착이 없는 연조직 종괴로 보이다가 한 달 이내에 빠른 속도로 연조직 종괴의 골화가 확인되었고, 고체형 골막반응이 동반되었다.

Florid reactive periostitis (FRP) is a rare benign fibro-osseous proliferation, occurring mostly in the short tubular bones of hands and rarely in the long tubular bones. We report a surgically confirmed case of FRP involving the clavicle in a 26-year-old male. On MRI scans, a soft tissue mass with T2 high signal intensity was found that originated from the periosteum of the clavicle and included surrounding a periosteal elevation and perilesional soft tissue edema. Strong contrast enhancement was noted inside the mass and along the periosteum involving more than half of the circumference of the clavicle. Serial radiographs revealed a soft tissue mass without mineralization that turned into an ossified mass with a solid periosteal reaction within a month.

키워드

참고문헌

  1. Spjut HJ, Dorfman HD. Florid reactive periostitis of the tubular bones of the hands and feet. A benign lesion which may simulate osteosarcoma. Am J Surg Pathol 1981;5:423-433  https://doi.org/10.1097/00000478-198107000-00002
  2. Jamshidi K, Givehchian B, Mirzaei A. Florid reactive periostitis of the long bone: a case series of seven patients. J Orthop Sci 2017;22:560-565  https://doi.org/10.1016/j.jos.2016.12.015
  3. Yamamoto T, Marui T, Mizuno K, Obayashi C, Minami R, Inaba M, et al. Parosteal fasciitis of the clavicle. Pathol Int 2000;50:987-991  https://doi.org/10.1046/j.1440-1827.2000.01148.x
  4. Kwittken J, Branche M. Fasciitis ossificans. Am J Clin Pathol 1969;51:251-255  https://doi.org/10.1093/ajcp/51.2.251
  5. Howard RF, Slawski DP, Gilula LA. Florid reactive periostitis of the digit with cortical erosion: a case report and review of the literature. J Hand Surg Am 1996;21:501-505  https://doi.org/10.1016/S0363-5023(96)80370-4
  6. Jambhekar NA, Desai SS, Puri A, Agarwal M. Florid reactive periostitis of the hands. Skeletal Radiol 2004;33:663-665  https://doi.org/10.1007/s00256-004-0760-3
  7. Sundaram M, Wang L, Rotman M, Howard R, Saboeiro AP. Florid reactive periostitis and bizarre parosteal osteochondromatous proliferation: pre-biopsy imaging evolution, treatment and outcome. Skeletal Radiol 2001;30:192-198  https://doi.org/10.1007/s002560100343
  8. Gao Z, Wang J, Wang Z, Meng Q. Florid reactive periostitis of the metacarpal and phalanx: 2 case reports. J Hand Surg Am 2013;38:2134-2137  https://doi.org/10.1016/j.jhsa.2013.08.115
  9. Guillin R, Moser T, Koob M, Khoury V, Chapuis M, Ropars M, et al. Subperiosteal hematoma of the iliac bone: imaging features of acute and chronic stages with emphasis on pathophysiology. Skeletal Radiol 2012;41:667-675  https://doi.org/10.1007/s00256-011-1267-3
  10. Seeger LL, Yao L, Eckardt JJ. Surface lesions of bone. Radiology 1998;206:17-33 https://doi.org/10.1148/radiology.206.1.9423647