Comparsion between imaging and pathological findings of fibrous dysplasia in limbs of children

Abstract

Objective To study the imaging and pathological characteristics of fibrous dysplasia of bone(FDB)in limbs of children, to improve knowledge and preoperative diagnosis of the disease. Methods From January 2011 to December 2016, the clinical features, imaging findings, pathologic features of 32 patients with limbs FDB confirmed by surgical pathologic in Children's Hospital of Nanjing Medical University were analyzed retrospectively. Of 32 patients, 19 patients were males, 13 patients were females. The average age was 9.2 years (2 to 14 years). X-ray examination was performed in 32 patients, CT scan and 3D reconstruction in 30 patients, and MRI examination in 14 patients. All imaging data, including shape, location, boundary, combined pathologic fracture or not and so on, were analyzed, those imaging features and pathology were compared and analyzed. Results Twenty-seven patients with single bone lesions including 15 lesions in the femur, 7 lesions in the tibia, 1 lesion in the fibula, 2 lesions in the humerus, and 2 lesions in the ulna. Four patients with multiple bone lesions including lesions were located in the femur and tibiofibula in 2 patients, femur and occipital bone in one patient, and ulna and radius in one patient. One patient with McCune-Albright syndrome was located in right femur, ilium and pubis. Pathologic fracture was seen in 11 patients. Histological examination revealed fibrous dysplasia was bone developmental anomaly characterized by replacement of normal bone and marrow bone by fibrous tissue. Imaging with ground-glass like changes, pathology of the mature fibrous tissue was leathery. Imaging showed cystic expansion translucent changes, pathological manifestations often dominated by fibrous tissue active growth, qualitative change mucoid degeneration and cystic changes. Imaging vegetable sponge like changes, the pathological manifestations for the hyperplasia of fibrous tissue and new bone trabecula distributed hybrid. Conclusions FDB of limbs usually involves femur and tibia. The images of FDB have some characteristic including ground-glass form images and expansive images. Pathological features showing normal bone marrow tissues are replaced by a large number of fibrous tissues. The different imaging changes have their corresponding pathological characteristics. Key words: Fibrous dysplasia of bone; Child; Long bone; Pathology; Imaging