Cocco R, Galieni P, Bellan C, Fioravanti A
Istituto di Reumatologia, Università degli Studi di Siena.
Ann Ital Med Int. 1999 Apr-Jun;14(2):118-23.
We describe 4 cases of malignant lymphoma (3 women, 1 man, age range 20-49 years) presenting with a tender and fusiform swelling at the level of the upper costosternal joints, with the clinical characteristics of classic Tietze's syndrome. Physical examination, laboratory findings and chest X-rays all were negative, while telethermography examination evidenced an area of hyperthermia at the level of the swelling in the chondrosternal region. Tietze's syndrome was diagnosed and the patients were treated with non-steroidal anti-inflammatory drugs and a local injection of corticosteroid. The clinical picture did not change, and in 2 cases a cervical lymphadenopathy developed. A biopsy of the lymph nodes and articular tumefaction disclosed Hodgkin's disease in 3 cases and non-Hodgkin's lymphoma in 1 case. Computerized tomography, lymphography and bone marrow biopsy permitted the complete staging of the lymphoma. After beginning a therapeutic program with chemotherapy and irradiation therapy, all 4 patients underwent complete remission.
我们描述了4例恶性淋巴瘤患者（3名女性，1名男性，年龄范围20 - 49岁），他们在上肋胸关节水平出现压痛性梭形肿胀，具有典型蒂策氏综合征的临床特征。体格检查、实验室检查结果及胸部X线检查均为阴性，而远红外热像图检查显示肋软骨区域肿胀处有热区。诊断为蒂策氏综合征，患者接受了非甾体类抗炎药治疗及局部注射皮质类固醇。临床症状未改善，2例患者出现颈部淋巴结病。对淋巴结及关节肿物进行活检，3例确诊为霍奇金病，1例为非霍奇金淋巴瘤。计算机断层扫描、淋巴造影及骨髓活检确定了淋巴瘤的完整分期。在开始化疗和放疗的治疗方案后，所有4例患者均完全缓解。
