Aneurysmal Bone Cyst: its Pathogenesis Based on Angiographic, Immunohistochemical and Electron Microscopic Studies

Miklós SZENDRŐI1, Gabriella ARATÓ3, Ali EZZATI1, Kálmán HÜTTL2, Péter SZAVCSUR4

1Department of Orthopaedics, Semmelweis University of Medicine, Budapest, Hungary
2Department of Vascular Surgery, Semmelweis University of Medicine, Budapest, Hungary
3Department of Pathology, Imre Haynal University of Public Health, Budapest, Hungary
4Department of Radiology, National Institute of Oncology, Budapest, Hungary


Based on angiographic, immunohistochemical as well as electron microscopic findings, authors outline a hypothesis for the etiopathogenesis of aneurysmal bone cysts. No changes were found at the arterial site in 16 studied aneurysmal bone cysts, with no signs of an arteriovenous shunt. In certain cases, however, dilated and tortous efferent veins became visible in the late venous phase. Due to the impedance of venous flow, the intracystic pressure increases and the small veins become dilated causing formation of aneurysmal slits. This is supported by the immunohistochemical finding that S-actin shows concentric arrangement around the aneurysmal cavities. Endothelial lining and basal membrane remnants were detectable in places, though the aneurysmal slits were devoid of continuous endothelial lining and basal membrane. We suggested that the aneurysmal bone cyst corresponds to a hemodynamic disturbance and is due to primary or secondary venous malformation of the bones. Pathology & Oncology Research, Vol 4, Nr 4, 277-281, 1998

Key words: aneurysmal bone cyst; pathogenesis; angiography; histology

Received: Sep 9, 1988; accepted: Nov 12, 1998
Correspondence: Miklós SZENDRŐI, Department of Orthopaedics, Semmelweis University of Medicine, Karolina út 27 Budapest H-1113, Hungary; Tel: +36-1-4666059, Fax: +36-1-4668747

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