Pediatric Unilocular Bone Cyst
Introduction
Introduction to pediatric single-atrial bone cyst A single atrial bone cyst (solitarybonecyst) is not uncommon. The capsule is a single cavity with a thin film and a grassy yellow liquid. The disease occurs in children and adolescents, and there are more males. Bone cysts are often located on the metaphysis of the humerus and femur. The cystic wall is often found accidentally due to trauma or even pathological fracture, or the lesion of the upper femur is often caused by abnormal gait. The initial lesion originates from the metaphyseal end of the adjacent tarsal plate and moves away from the tarsal plate. The upper end of the humerus accounted for 50%, followed by the upper and lower ends of the femur and the proximal humerus, occasionally in the calcaneus, metacarpal and humerus. Recently, there have been reports of osteophytes, and the prognosis of this disease is good. basic knowledge The proportion of illness: 0.002% Susceptible people: children Mode of infection: non-infectious Complications: fracture gait abnormalities
Cause
The cause of pediatric single-atrial bone cyst
Causes:
The true cause is unknown, and it seems to be related to localized ossification of the metaphysis during the vigorous growth of the bone. Some authors suggest that the cancellous or intramedullary hemorrhage is the cause of a single cyst; another theory is cyst. The wall is composed of various primitive mesoderm components, so it is considered that the cyst originates from the tumor tissue with developmental disorders; or the cancellous bone with rapid growth can produce bone cysts. Some authors believe that the bone cyst is caused by mechanical external force damage. The result of intercellular fluid circulation blockade.
Pathogenesis:
The wall of the capsule, such as the thickness of the eggshell, causes the appearance of the capsule to be blue due to the liquid in the capsule. The wall of the capsule is cut and the liquid is discharged from the grass. If a pathological fracture has recently occurred, the liquid may be bloody, except for repeated fractures. There is a fibrous space in the cyst cavity, which is generally a single room. There is an epiphysis in the wall of the capsule. The cavity is lined with a layer of connective tissue film of about 1 mm, and the color is reddish brown.
Pathologically non-specific, the fibrous membrane is connective tissue, containing giant cells, phagocytic cells, hemosiderin-containing brown particles and yellow tumor cells, and reactive new bone formed after fracture of the cyst wall.
Prevention
Prevention of unilateral bone cyst in children
The cause is unknown, refer to the general tumor prevention methods, understand the risk factors of tumors, and formulate corresponding prevention and treatment strategies to reduce the risk of tumors. There are two basic clues to prevent tumors. Even if tumors have begun to form in the body, they can help the body. To increase resistance, these strategies are as follows:
1. Avoid harmful substances (promoting factors) that can help us avoid or minimize exposure to harmful substances.
Some related factors of tumorigenesis are prevented before the onset, and many cancers can be prevented before they are formed. A report in the United States in 1988 compared the international malignant tumors in detail and proposed many external factors of known malignant tumors. In principle, it can be prevented, that is, about 80% of malignant tumors can be prevented by simple lifestyle changes, and traced back. In 1969, Dr. Higginson's research concluded that 90% of malignant tumors are caused by environmental factors," "Environmental factors", "lifestyle" refers to the air we breathe, the water we drink, the food we choose to make, the habits of activities, and social relationships.
2. Improve the body's immunity against tumors, and help to strengthen and strengthen the body's immune system and cancer.
The focus of our current cancer prevention efforts should first focus on and improve those factors that are closely related to our lives, such as quitting smoking, eating properly, exercising regularly, and losing weight. Anyone who follows these simple and reasonable lifestyles can Reduce the chance of cancer.
The most important thing to improve the function of the immune system is: diet, exercise and control troubles. Healthy lifestyle choices can help us stay away from cancer. Maintaining good emotional state and proper physical exercise can keep the body's immune system at its best. Tumors and prevention of other diseases are equally beneficial. Other studies have shown that appropriate activities not only enhance the body's immune system, but also reduce the incidence of colon cancer by increasing the peristalsis of the human intestinal system. Here we mainly understand the diet in preventing tumorigenesis. Some questions.
Human epidemiology and animal studies have shown that vitamin A plays an important role in reducing the risk of cancer. Vitamin A supports normal mucosa and vision. It directly or indirectly participates in most of the body's tissue functions. Vitamin A is present in animal tissues. In the liver, whole eggs and whole milk, the plant is in the form of -carotene and carotenoids, which can be converted into vitamin A in the human body. Excessive intake of vitamin A can cause adverse reactions in the body and -carrot This is not the case with carotenoids, and the low vitamin A content in the blood increases the risk of malignant tumors. Studies have shown that those with low levels of vitamin A intake in the blood increase the likelihood of lung cancer, while those with low blood levels in smokers Levels of vitamin A ingestors have the potential to double lung cancer. Vitamin A and its mixture can help remove free radicals in the body (free radicals can cause damage to genetic material), and secondly stimulate the immune system and help differentiate cells in the body. Ordered tissue (while the tumor is characterized by disorder), some theories suggest that vitamin A can help early carcinogens Invasion mutated cells become reversed the occurrence of the normal growth of cells.
Complication
Pediatric single-atrial bone cyst complications Complications, abnormal gait
Can cause pathological fractures, abnormal gait, etc.
Symptom
Pediatric single-atrial bone cyst symptoms common symptoms gait abnormal bone thickening cortical bone thinning bone cyst
The wall of the cyst is often found accidentally due to trauma or even pathological fracture. Except for the injury, there is generally no pain. The lesion of the upper femur often attracts attention due to abnormal gait.
Bone cysts are often located on the metaphysis of the tibia and femur. Older patients are often located in the humerus, calcaneus and metacarpal. About 2/3 of the cases have no symptoms, and 1/3 of the cases have local pain, soreness, tenderness and tenderness. In a small number of patients, the local mass and bone thickening, the vast majority of patients in the occurrence or repeated pathological fractures to see a doctor.
Examine
Examination of pediatric single-atrial bone cyst
Pathological changes:
Gross shape
Atrial cysts, filled with a low viscosity clear liquid, sometimes a serous bloody liquid, the thickness of the wall is different.
2. Organizational form
Smooth for loose connective tissue, rich in blood vessels, scattered a small number of osteoclast-type giant cells, new bone-like tissue and braided bone, sometimes with new and old hemorrhagic foci or cholesterol fissures and clusters of foamy tissue cells, often present in the wall tissue Banded or agglomerated fibrous cord-like material, similar to cementum or glassy and calcified connective tissue.
X-ray examination: The cyst is usually located at one end of the long tubular bone. The cortical bone of the local backbone is slightly expanded outward. There is a small section of cancellous bone between the capsule and the tarsal plate. The distance between the cyst and the tarsal plate depends on the time of the lesion. Depending on the scope, occasionally the cyst penetrates the tarsal plate into the epiphysis. If a fracture occurs, the cancellous bone between the cyst and the tarsal plate can be deformed, but the fracture is mostly without displacement.
Diagnosis
Diagnosis and diagnosis of pediatric single-atrial bone cyst
diagnosis
The diagnosis of this disease mainly depends on X-ray examination and pathological biopsy. The X-ray photograph shows that the central large transparent area of the backbone is helpful for diagnosis, the local cortical bone is thin, and the volume is slightly expanded.
Differential diagnosis
1. Aneurysmal bone cyst: The single bone cyst is a central expansion, the ovarian dilatation of the tumorous bone cyst, the bone cyst contains a bloody fluid or blood clot, and the gross pathology of each Confusion, hyperparathyroidism is more common in adulthood, and elevated blood calcium can be identified.
2. Uni-bone fiber heterogeneous proliferation: The imaging of mono-bone fiber heterogeneous proliferation and single-bone cyst is similar. Fibrous bone lesions of fibrous abnormal proliferation show slender trabeculae in the ground-glass image, especially after amplification. In addition, most of the lesions that proliferate in the fiber are eccentrically dilated.
3. Giant cell tumor: single bone cyst should not be confused with giant cell tumor. Giant cell tumor occurs mostly in adults, almost all invade the ankle, and its tumor cell line is typical of spindle cells and oval interstitial cells. There are multinucleated giant cells scattered. Although bone cysts can see giant cells, they do not see interstitial cells.
4. Eosinophilic granuloma: clinical manifestations of pain, the lesion is more near the middle of the backbone, the size is not as large as the bone cyst, the new bone exceeds the lesion area, histological examination shows eosinophils.
5. Endogenous chondroma: Although it is cystic, it occurs in the backbone of short tubular bone. The chondroma often has a bit of calcified foci. In some cases, X-ray photographs cannot be taken alone and need to be examined by histological examination.
