颞下颌关节滑膜软骨瘤病的病理特征

doi:10.13701/j.cnki.kqyxyj.2017.11.001

口腔医学研究 ›› 2017, Vol. 33 ›› Issue (11): 1135-1138.DOI: 10.13701/j.cnki.kqyxyj.2017.11.001

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颞下颌关节滑膜软骨瘤病的病理特征

李颖杰, 冯亚平, 邓末宏, 龙星^*

武汉大学口腔医院第二颌面外科湖北武汉 430079

收稿日期:2017-05-01 出版日期:2017-11-20 发布日期:2017-11-29
通讯作者: 龙星,E-mail: longxing@whu.edu.cn
作者简介:李颖杰(1985~ ),男,湖北武汉人,博士,主治医师,主要从事颞下颌关节疾病相关研究。
基金资助:
国家自然科学基金资助项目(编号:81600889)
武汉大学青年教师资助项目 (编号:2042015kf0150)

Pathologic Changes of Synovial Chondromatosis of Temporomandibular Joint.

LI Ying-jie, FENG Ya-ping, DENG Mo-hong, LONG Xing^*

Department of 2nd Oral and Maxillofacial Surgery, School of Stomatology, Wuhan University, Wuhan 430079, China

Received:2017-05-01 Online:2017-11-20 Published:2017-11-29

摘要/Abstract

摘要： 目的:揭示颞下颌关节(TMJ)滑膜软骨瘤病(SC)的组织学特征及推动病理过程发展的关键因素。方法:常规组织学方法处理游离体与滑膜组织。结果:Milgram Ⅰ期,长30 μm 软骨瘤体形成于血管丰富的滑膜衬里下层。Milgram Ⅱ期,长0.5 mm 软骨瘤体从滑膜上脱离,成为游离体,被关节滑液滋养,其长可增长至3 mm。Milgram Ⅲ期,骨小梁结构取代了一枚长为4.3 mm游离体的大部分软骨细胞外基质。结论:Milgram Ⅰ期,滑膜血管生成增多保证软骨瘤体形成时的充足营养供应;Milgram Ⅱ期,关节滑液的充足营养使得游离体体积进一步增大;Milgram Ⅲ期,游离体通过骨化的方式改变自身结构使得滑液中营养更易渗入其深处。因此,软骨瘤体或游离体对营养的需要推动了TMJSC病理过程的发展。

关键词: 滑膜软骨瘤病, Milgram分期, 滑膜软骨化生, 成骨分化

Abstract: Objective: To investigate the histological features of synovial chondromatosis (SC) of temporomandibular joint (TMJ) and the key to promote pathogenic process. Methods: Loose bodies(LBs)and synovium specimens were treated with histological methods. Results: During Milgram phaseⅠ, cartilaginous nodules (CNs) with a length of 30μm formed in synovium's sublining layer rich in blood vessels. During Milgram phaseⅡ, CNs with a length of about 0.5mm detached from synovium and became LBs which were nurtured by synovial fluid. The length of LB could increase to 3 mm. During Milgram phase Ⅲ, bone trabecular replaced the majority of cartilaginous extracellular matrix in the LB with a length of 4.3mm. Conclusion: During Milgram phaseⅠ, angiogenesis guaranteed enough nutrients supply for CNs formation. During Milgram phaseⅡ, enough nutrients supply from synovial fluid facilitated further volume increase of LBs. During Milgram phase Ⅲ, LB suffered from ossification and structure changes in order for more nutrients permeation into deep area. Therefore, the need of CNs or LBs for nutrients promoted the pathogenic process of TMJSC.

Key words: Synovial chondromatosis, Milgram classification, Synovium cartilaginous metaplasia, Ossification

中图分类号:

R782.6

李颖杰, 冯亚平, 邓末宏, 龙星. 颞下颌关节滑膜软骨瘤病的病理特征[J]. 口腔医学研究, 2017, 33(11): 1135-1138.

LI Ying-jie, FENG Ya-ping, DENG Mo-hong, LONG Xing. Pathologic Changes of Synovial Chondromatosis of Temporomandibular Joint.[J]. Journal of Oral Science Research, 2017, 33(11): 1135-1138.

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颞下颌关节滑膜软骨瘤病的病理特征

Pathologic Changes of Synovial Chondromatosis of Temporomandibular Joint.

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