• 제목/요약/키워드: giant cell tumor of bone

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양성 거대 세포종의 악성 변화 (Malignant Transformation of Benign Giant Cell Tumor)

  • 공창배;홍윤석;이광열;조상현;송원석;조완형;고재수;전대근
    • 대한골관절종양학회지
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    • 제18권1호
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    • pp.14-19
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    • 2012
  • 목적: 저자들은 골육종으로 악성 변화한 거대 세포종 환자의 종양학적 결과에 대해 알아보고자 하였다. 대상 및 방법: 2000년 1월부터 2012년 2월까지 외부에서 양성 거대 세포종으로 진단받은 뒤 치료받고 재발한 후 악성 변화가 의심되어 본원으로 전원된 5명의 환자를 대상으로 하였다. 5명 환자 모두 방사선 치료를 시행받은 병력은 없었다. 결과: 모든 환자는 광범위 절제술 시행받았고, 술 후 조직병리 검사상 골육종으로 확진되었다. 원발성 병변은 원위 대퇴골 3명, 근위 대퇴골 1명, 원위 요골 1명이었다. 양성 거대 세포종으로 진단받고 악성 변화하기까지 기간은 평균 49.2개월(24-126개월)이었다. 평균 추시 기간은 21.6개월이었다. 본원에서 광범위 절제술을 시행 받았음에도 3명에서 원격 전이가 발생하였고, 이들 중 2명의 환자에서는 국소 재발도 확인되었다. 이들 3명 모두 사망하였다. 결론: 본 증례로 보아 적절한 치료를 받은 양성 거대 세포종 환자에서도 악성 변화는 5년 이내에 발생할 수 있다. 따라서, 정기적 추시 중 방사선학적으로 육종 변화가 의심되는 경우 보다 적극적인 치료가 필요하다고 생각된다.

늑골에서 발생한 골 거세포종 -1예 보고- (Giant cell tumor arising from the rib - A case report-)

  • 주홍돈;박경신;임승평
    • Journal of Chest Surgery
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    • 제24권10호
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    • pp.1024-1027
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    • 1991
  • We experienced a case of giant cell tumor arising from the right 2nd rib in the diagnostic and therapeutic thoracotomy at our department of Thoracic and Cardiovascular Surgery, Chungnam Univ. Hospital in May 3rd, 1991. The reports of this tumor are very rare and are known to have the incidence of 1 percent or less of all giant cell bone tumor. The tumor of the right 2nd rib, infant head-sized, covered with parietal pleura was invaded into the vertebra on operation finding. The tumor was resected partially[three fourths] and revealed to be the giant cell tumor on pathologic finding. At now, the patient is taking the radiotherapy to achieve the therapeutic goal to the remnant tumor.

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삼각근내 발생한 미만형 거대세포종 (Diffuse-Type Giant Cell Tumor in Deltoid Muscle)

  • 전영수;이상훈;이동기;김정연;김정석;한정수
    • 대한골관절종양학회지
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    • 제19권2호
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    • pp.87-91
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    • 2013
  • 미만형 거대세포종은 상대적으로 국소형 거대세포종에 비해 드문 것으로 알려져 있으며 관절외 발생하는 경우는 극히 드물다고 알려져 있다. 이에 저자들은 삼각근 내에 발생한 미만형 거대세포종 1예를 경험하여 이를 문헌고찰과 함께 보고하고자 한다.

슬관절내에 발생한 국소형 거대 세포종 - 1예 보고 - (Localized Giant Cell Tumor in Knee Joint - 1 Case Report-)

  • 조진호;왕국현
    • 대한골관절종양학회지
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    • 제13권2호
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    • pp.190-194
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    • 2007
  • 거대 세포종은 서서히 자라는 일측성의 국소형 종물로서 수부에서 흔하고 고관절, 족지관절에서도 보고되나 슬관절내에서는 드물게 발생한다. 이에 저자들은 슬관절 관절강내에서 발생한 거대 세포종 1예를 관절경하에 제거한뒤 병리학적으로 확진하였으며 이를 문헌고찰과 함께 보고하고자 한다.

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간의 파골세포모양 거대세포 종양의 세침흡인 세포학적 소견 (Fine Needle Aspiration Cytology of Osteoclast-like Giant Cell Tumor of the Liver)

  • 박찬식;김지은;장미수
    • 대한세포병리학회지
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    • 제10권1호
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    • pp.79-84
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    • 1999
  • Osteoclast-like giant cell tumor of the liver is an extremely rare malignancy with poor prognosis. To our knowledge, 5 cases have been reported in English literatures, but there was no report about fine needle aspiration cytologic(FNAC) features. We experienced a case of osteoclast-like giant cell tumor of the liver obtained by computed tomography(CT)-guided FNAC and needle biopsy. The cytologic findings mimicked slant cell tumor of the bone. A large hepatic mass of the left lobe with abdominal wall invasion was found by CT in a 46- year-old female complaining of epigastric pain. The FNAC showed moderately cellular smears consisting of osteoclast-like giant cells and mononuclear cells, which were individually scattered or intermingled in clusters. The osteoclast-like giant cells had abundant cytoplasms and multiple small round nuclei with fine chromatin and distinct nucleoli. The mononuclear cells had moderate amount of cytoplasm and relatively bland-looking oval nuclei with single small nucleoli. All of the cytologic features recapitulated the histologic findings of bland-looking osteoclast-like multinucleated giant cells evenly dispersed throughout the background of mononuclear cell. The immunohistochemical study showed positive reaction for CD68 and vimentin, but negative for cytokeratin in both osteoclast-like slant cells and mononuclear cells.

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생비골 이식술을 이용한 거대세포종의 치료 (Free Vascularized Fibular Graft for the Treatment of Giant Cell Tumor)

  • 한정수;유명철;정덕환;남기운;박보연
    • Archives of Reconstructive Microsurgery
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    • 제1권1호
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    • pp.31-38
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    • 1992
  • The management of giant cell tumor involving juxta-articular portion has always been a difficult problem. In certain some giant cell tumors with bony destruction, a wide segmental resection may be needed for preventing to recur. But a main problem is preserving of bony continuity in bony defect as well as preservation of joint function. The traditional bone grafts have high incidence in recurrence rate, delayed union, bony resorption, stress fracture despite long immobilization and stiffness of adjuscent joint. We have attemped to overcome these problems by using a microvascular technique to transfer the fibula with peroneal vascular pedicle as a living bone graft. From Apr. 1984 to Nov. 1990, we performed the reconstruction of wide bone defect after segmental resection of giant cell tumor in 4 cases, using Vascularized Fibular Graft, which occur at the distal radius in 3 cases and at the proximal tibia in 1 case. An average follow-up was 2 years 8 months, average bone defect after wide segmental resection of lesion was 11.4cm. These all cases revealed good bony union in average 6.5months, and we got the wide range of motion of adjacent joint without recurrence and serious complications.

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골 거대세포종의 2예 세침 천자 세포학적 소견 (Two Cases of Giant Cell Tumor of the Bone Diagnosed by Fine Needle Aspiration Cytology)

  • 명나혜;하창원;조경자;장자준;백구현;이수용
    • 대한세포병리학회지
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    • 제1권1호
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    • pp.93-97
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    • 1990
  • Two cases of giant cell tumor of bone diagnosed by fine needle aspiration cytology are described. Case 1 was a 28-year-old male who had pain sense for one year at the right distal thigh. His radiologic finding revealed a destructive cortical lesion with soft tissue extension at medial side of epiphysis of the distal femur. Case 2 was a 21-year-old female complaining pain at left distal forearm for eight months and showed a well-demarcated expansile osteolytic lesion with multiseptation, and cortical destruction at epiphysis and metaphysis of the left distal radius on the X-ray. Fine needle aspiration of each lesion was performed. The aspirate of the case 1 revealed moderate cellularity, which was composed of scattered giant cells of osteoclastic type and small round to oval monotonous stromal cells in large areas. Giant cells were evenly distributed in single or small groups and had irregular but abundant cytoplasms with 10 to 20 nuclei in the center. The nuclei showed ovoid shape, fine granular chromatin, and a small but conspicuous nucleolus. Stromal cells were dispersed in isolated pattern or sometimes aggregated in clusters and showed the same nuclei as those of giant cells and scanty cytoplasms. Comparing to case 1, case 2 had a more translucent abundant cytoplasm in the giant cells and more spindled stromal cells. All two cases revealed neither nuclear atypism nor increased abnormal mitoses In both giant and stromal cells, suggesting no evidence of malignancy. Thereafter the lesions were treated with excision and curettage, and histologically confirmed as giant cell tumors of the bone.

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Macrophagal Polykaryocytes in Inflammation, Tumor Growth, and Tissue Remodeling

  • Schepetkin, Igor-A.;Kiran, Kondaragil-R.;Kwon, Byoung-S.
    • Journal of Microbiology and Biotechnology
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    • 제11권5호
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    • pp.727-738
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    • 2001
  • Macrophagal polykaryocytes (MPs) are terminally differentiated multinuclear macrophage cells responsible for remodeling and resorption of bone, foreign body, and tissue deposition in inflammation. MPs are encountered only in bone and cartilagenous tissues, in which they are referred to as osteoclasts, odontoclasts, in which they are referred to as osteoclasts, odontoclasts, and septoclasts. Depending on the disease, the MPs differentiate into many morphological variants that include foreign-body giant cells, Langhans-type cells, and Touton-type cells. Morphological heterogeneity of MPs could Touton-type cells. Morphological heterogeneity of MPs could reflect the giant cell formation from phenotypically different marophage precursors by the process of fusion. At present, many cytokines, adhesion/fusion molecules, and other factors of the microenvironment have been discovered that influence the multinucleation process. Many evidences suggest that conditions in giant cell fibrohistiocytomas, which facilitate MP formation, are similar to the inflammation site of granulomatosis. MPs in the giant cell tumors and granulomatosis foci are formed in response to the factors secreted by mesenchymal cells. It is proposed that one of the first steps in vertebrate evolution could be the organization of skeleton remodeling, in which osteoclasts play a major role. In this step, the same mechanism of regulations served as a basis for the development of both osteoclast and inflammatory forms of MPs.

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골종양에서 탈륨 스캔의 정량적 분석 (Quantitative Analysis of Thallium-201 Scintigraphy in Bone Tumor)

  • 신덕섭;조인호
    • 대한골관절종양학회지
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    • 제9권1호
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    • pp.45-51
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    • 2003
  • 목적: 골종양이 의심되는 환자들에게 탈륨 스캔을 시행하여 섭취 정도를 정량적으로 측정하고 비교 분석하여 탈륨 스캔의 악성 골종양 조직에 대한 판별 능력을 규명하고자 한다. 대상 및 방법: 골종양이 의심되는 82명의 환자에 대하여 조직 생검 전에 다른 영상검사와 함께 전향적으로 탈륨 스캔을 시행하였다. 스캔의 결과는 정성적 판독과 정량적 탈륨 섭취율을 측정하였으며, retention index(delayed/early phase의 탈륨 섭취량)를 구하였다. 결과의 분석을 위하여 고등급 악성 골종양 군, 양성 골종양 군, 거대세포종 군 및 저등급 악성 골종양 군으로 나누고 각 그룹간의 통계적 유의성을 조사하였다. 결과: 탈륨 섭취율의 정량적 측정에서는 고등급 악성 골종양 군에서는 early phase에 평균 4.14, delayed phase에서는 평균 2.26였으며, 양성 골종양 군에서는 각각 1.16과 1.09, 거대세포종 군에서는 3.15와 1.94, 저등급 악성 골종양 군에서는 1.41과 1.31이었다. Retention index는 고등급 악성 골종양 군에서는 평균 0.62, 양성 골종양 군에서는 0.97, 거대세포종 군에서는 0.66, 저등급 악성 골종양 군에서는 0.93이었다. 고등급 악성 골종양 군은 early phase와 delayed phase의 탈륨 섭취율이 거대세포종을 제외한 양성 골종양 군 보다 유의하게 높았으며(p<0.001), retention index는 유의하게 낮았다(p<0.001). 결론: 탈륨 스캔은 악성 골종양과 대부분의 양성 골종양을 구분 할 수 있는 유용한 검사라고 사료되지만, 거대세포종의 경우 악성 골종양 같이, 저등급 악성 골종양의 경우 양성 골종양 같이 나타나는 특성에 유의하여 사용하여야 할 것이다.

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