Lumbalgie als symptoom van een extramedullaire tumor bij acute myeloïde leukemie

I. Schoolmeesters, K. Kempeneers, B. Sciot, X. Huybrechts
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Abstract

Lumbago as a symptom of an extramedullary tumour in acute myeloid leukaemia A 58-year-old man with acute myeloid leukaemia presents with low back pain. Because of his oncologic history and severe pain during the night, additional radiographic imaging was performed. These alarm signals or so-called red flags are described in the guidelines of the Belgian Health Care Knowledge Centre (KCE). Imaging showed a mass at the 10th thoracic vertebra, suspected to be an extramedullary tumour consisting of myeloblasts, originating from the previously diagnosed acute myeloid leukaemia. A biopsy confirmed this diagnosis. Since these tumours present with different symptoms and at different locations, every physician should be aware of them. They are treated systemically with chemotherapy, like the intramedullary disease, sometimes supplemented with local therapy. In some cases, this disease manifestation presents prior to or without the diagnosis of acute myeloid leukaemia. A correct histological diagnosis is then essential for a correct treatment.
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腰痛是急性髓性白血病髓外肿瘤的症状之一
腰痛是急性髓系白血病髓外肿瘤的症状 一名 58 岁的急性髓系白血病患者出现腰痛。由于他有肿瘤病史,而且夜间疼痛剧烈,因此进行了额外的放射成像检查。比利时医疗保健知识中心(KCE)的指南中描述了这些报警信号或所谓的 "红旗"。影像学检查显示,第10胸椎处有一个肿块,怀疑是由髓母细胞组成的髓外肿瘤,源于之前确诊的急性髓系白血病。活组织检查证实了这一诊断。由于这些肿瘤的症状和发病部位各不相同,每位医生都应该对它们有所了解。与髓内肿瘤一样,这些肿瘤也需要接受全身化疗,有时辅以局部治疗。在某些情况下,这种疾病的表现会出现在急性髓性白血病确诊之前或没有确诊的情况下。因此,正确的组织学诊断是正确治疗的关键。
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