A brief talk about knowledge of fibroids

Fibroids are also quite common in daily life. Many patients think that fibroids are not a big deal. Although they will not endanger the health of the body for the time being, they will still cause harm to the body if not treated for a long time. So, let us briefly talk about the knowledge of fibroids, hoping to help everyone learn more about this disease.

There are different opinions on the relationship between non-osteogenic (non-ossifying) fibroma and metaphyseal fibrous defect (fibrous cortical bone defect). Some believe that the former is tumorous, while the latter can occur multiple times and automatically degenerate and disappear, and is classified as a tumor-like lesion. It occurs between 5 and 20 years old and is more common in the tibia, femur, and fibula.

X-rays show eccentric, multilocular lesions with clear borders or sclerosis located in the metaphysis. Microscopically, dense fibrous tissue is arranged in bundles or in a whirlpool shape, and multinucleated giant cells, foam cells and hemosiderin deposition are seen.

Ossifying fibroma usually refers to a tumor located in the jawbone. Recently, there have been reports of "ossifying fibroma" occurring in long bones. Microscopically, it is composed of fibrous tissue and trabeculae with osteoblasts. It is also called "dysplastic fibrous bone disease".

Desmoid fibroma of bone is a bone tumor that is similar to desmoid fibroma of soft tissue in pathological manifestations and completely different from other bone fibromas (non-osteogenic fibroma, chondromyxoid fibroma). It occurs between the ages of 11 and 30 and is located in long bones or flat bones.

X-rays show extensive osteolytic destruction, which may be uniform or foamy. The cortical bone expands and thins, and the marginal bone shows reactive hyperplasia. After penetrating the cortical bone, a soft tissue mass is formed, which resembles a malignant tumor. Microscopically, the fibroblasts are relatively mature and small. There are no dark-stained nuclei or large nuclei and nuclear division. There are many collagen fibers, which are wide and thick collagenized cords, wavy or bundled, or form dense transparent masses. There are no multinucleated giant cells, foam cells and metaplastic bone formation. It should be carefully differentiated from well-differentiated fibrosarcoma.

Fibrosarcoma (medullary cavity, central) usually occurs in the 20 to 60 years old, and is more common in the femur and tibia. X-rays show that it is located at the epiphysis or at the bone end, with an infiltrative, osteolytic, uneven, and blurred edge. After penetrating the cortical bone, a soft tissue mass is formed. Under the microscope, spindle-shaped fibroblasts are seen, with sharp nuclei at both ends, forming reticular fibers and collagen fibers.

In addition, macrophages, hemosiderin deposition, and occasional multinucleated giant cells were observed. Pathological grading was performed based on the number of tumor cells, degree of anaplasia, number of nuclear divisions, and number of collagen fibers formed.

"Extra-mandibular" myxoma refers to a myxoma that is different from the odontogenic myxoma that occurs in the jaw, and is not a chondromyxoid fibroma or myxochondrosarcoma. It can occur in the pelvis and long bones of middle-aged people, and appears as a clearly demarcated osteolytic destruction on X-ray. Microscopically, myxoid matrix and astrocytes are seen, and the nuclei are mostly spindle-shaped. The nuclei are uniform in size and do not show polymorphism. Occasionally, collagen formation or calcification is seen, which has recently been proposed as a "fibromyxoma".