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患者,男性,21岁。左上胸壁肿物伴疼痛半年入院治疗。查体:左上胸壁局限性膨隆,触及一肿物、质硬、不活动、表面欠光滑、有压痛、皮肤色泽正常。全身浅表淋巴结不大,心肺无异常。实验室检查正常。CT扫描所见:左上胸壁第二肋骨前段骨皮质呈椭圆形膨胀性改变,大小约3.3cm×6.6cm,边界清楚,并向胸内突入,边缘呈环状硬化,无骨膜反应,其内密度不均匀,可见细小的骨嵴(图1)。手术与病理:术中见病肋呈骨皮质膨胀变薄的骨性肿物,大小约7.0cm×5.0cm×3.5cm,病段肋骨骨膜有异常血管网,与正常骨膜分界清楚,切除病段肋。病理诊断:肋骨骨化性纤维瘤(图2)
Patient, male, 21 years old. Left upper chest wall mass with pain for half a year admitted to hospital. Physical examination: limitations of the left upper chest wall bulging, touching a tumor, hard, inactive, the surface is less smooth, tenderness, skin color is normal. Superficial superficial lymph nodes are small, and there are no abnormalities in heart and lungs. Normal laboratory tests. CT scan findings: the left upper chest wall of the second rib anterior segment of the cortical elliptic expansion changes, the size of about 3.3cm × 6.6cm, the boundary is clear, and intrusion into the chest, the edge was ring hardening, no periosteal reaction, the internal density Inhomogeneous, tiny bones can be seen (Figure 1). Surgical and pathological: During the operation, the diseased ribs show bone cortical bone expansion and thinning, about 7.0cm×5.0cm×3.5cm in size, abnormal vascular network in the rib periosteum of the diseased segment, clear boundary with normal periosteum, resection of the disease segment. rib. Pathological diagnosis: ossification fibroma of the rib (Figure 2)