Ayoub Jaafari, Ornella Rizzo, Sohaïb Mansour, Anas Chbabou, A. Trépant, Rachid Attou, Celine Mathey
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引用次数: 0
摘要
脊柱原发性骨淋巴瘤(PBL)是一种罕见的疾病,由于其位置不典型,临床和影像学特征与某些病变相似,可能被误诊为感染性过程,从而使诊断复杂化并延误诊断。我们的病例报告了一名六十多岁的患者,她患有慢性腰背痛一年,并逐渐开始出现嵴髓痛。她接受了血液采样、磁共振成像(MRI)和正电子发射断层扫描(18F-FDG-PET/CT)检查,结果显示她患有炎症综合征,腰椎脊柱盘炎,伴有形态学和代谢学上的后方广泛侵犯,提示有硬脊膜炎。身体其他部位未发现其他病变。患者接受了神经外科治疗,并进行了活组织检查。组织学结果显示为侵袭性弥漫大 B 细胞淋巴瘤,提示诊断为 PBL。本病例强调了腰椎中第一例模仿 PBL 的脊柱盘炎、诊断工作的复杂性以及与脊柱感染过程鉴别的复杂性,因为两者具有相似的非特异性临床表现,而形态学和代谢结果可能相似。
Case report: When infection lurks behind malignancy: a unique case of primary bone lymphoma mimicking infectious process in the spine
Primary bone lymphoma of the spine (PBL) is a rare entity that may be misdiagnosed due to its atypical location and clinical and imaging features mimicking certain pathologies as infectious processes, which complicates and delays diagnosis. Our case reports a patient in her sixties who had been suffering from chronic low back pain for a year, and had gradually started to develop cruralgia. She underwent a blood sample, magnetic resonance imaging (MRI), and positron emission tomography (18F-FDG-PET/CT) which revealed inflammatory syndrome, and an image of spondylodiscitis of the lumbar spine associated with a morphological and metabolical widespread invasion posteriorly suggesting epiduritis. No other lesions were found on the rest of the body. Neurosurgical management was performed and a biopsy was made. Histological results showed aggressive and diffuse large B-cell lymphoma, suggesting a diagnosis of PBL. This case highlights the first case of spondylodiscitis mimicking PBL in the lumbar spine, the intricacies of the diagnostic work-up, and the complexity of discriminating with an infectious process in the spine, as both have a similar, non-specific clinical presentation, while morphological and metabolic findings can be alike.