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上期试题：以下关于脊索瘤的叙述中，错误的是E
A.几乎都有骨质破坏
B.好发部位是骶尾部，其次是颅底
C.脊索瘤软组织肿块呈分叶状，半数以上有钙化
D.脊索瘤起源于骨内残留的迷走脊索组织
E.骶尾部脊索瘤好发于骶3以下
患者，男，77岁，腰痛伴双下肢疼痛2个月。双下肢活动无障碍，大小便正常。
查体：腰椎生理曲度存在，腰椎活动受限，双下肢感觉正常，肌张力正常。双膝腱反射正常，跟腱反射未引出。双巴氏征（—），双直腿抬高试验（—）
X线平片
腰3椎体局部骨小梁稀疏、粗大，呈栅栏状。
CT平扫
腰3椎体局部密度降低，残留骨小梁粗大、稀疏，骨小梁之间呈脂肪密度，矢状及冠状位重建图像可见栅栏状改变。椎体骨皮质完整，无软组织肿块。
T1WI抑脂增强
腰3椎体病变呈明显不均匀性强化，内见斑点状及线状无强化区。
骨血管瘤在组织学上是一种呈瘤样增生的血管组织，掺杂于骨小梁之间，部分骨小梁被压迫吸收，其余部分则反应性增粗，分为海绵型血管瘤和毛细血管瘤。可发生于任何年龄，以中老年多见，好发于脊柱、颅骨、长骨等。根据其所在部位，可发生相应的临床症状。发生于脊柱的血管瘤X线表现为椎体内粗大骨小梁呈栅栏状、网格状排列，无软组织肿块及骨膜反应；CT平扫表现为骨松质呈粗大网眼状、残留骨小梁粗大，周围可见脂肪沉积，矢状位和冠状位重建图像上呈栅栏样改变，CT增强扫描因大量粗大的骨小梁存在，强化表现不明显，延伸到椎旁软组织内的血管瘤可呈明显强化。MRI表现为血管瘤在T1WI像呈稍低、等或稍高信号，T2WI像呈均匀的高信号，MR增强扫描后血管瘤呈明显强化。
Bit of hemangioma is a kind of show on histologic tumor vascular tissue hyperplasia, doping in the trabecular bone, part of the oppression of the trabecular bone absorption, the rest is reactive enlargement, divided into sponge type hemangioma and capillary tumor. Can occur at any age, in middle and old age, good hair in the spine, skull, long bone and so on. According to its location, corresponding clinical symptoms can occur. The X-ray of the hemangioma of the vertebral column was presented as a palisade, grid arrangement, no soft tissue mass and periosteum reaction. CT scan of cancellous bone bulky mesh shaped, residual bone trabecular thick, fat deposits around, sagittal and coronal reconstruction images on a fence sample change, CT enhanced scan for a large number of bulky of trabecular bone, to strengthen the performance is not obvious, extends to the vertebral side of soft tissue hemangioma can show obvious reinforcement. MRI showed that hemangioma was slightly lower in the T1WI image, etc., and the T2WI was like a uniform high signal, and MR enhanced the hemangioma after scanning.
本例应与椎体不均匀脂肪沉积鉴别。椎体不均匀脂肪沉积病灶内无粗点状、栅栏状粗大骨小梁，T2WI抑脂像上信号低于正常松质骨。
This case should be identified with the inhomogeneous fat deposition of the vertebral body. There was no coarse, palisade and large bone trabecula in the lesion, and T2WI was less than normal cancellous bone.
本期试题：关于骨肿瘤好发部位，下列描述错误的是？
A．血管瘤：椎体、颅骨
B．软骨瘤：手的短管状骨
C．骨样骨瘤、尤文肉瘤：长骨骨干
D．成骨肉瘤：长骨干骺端
E．骨巨细胞瘤：扁骨
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