Perlick L, Bäthis H, Zhou H, Diedrich O
Klinik und Poliklinik für Orthopädie, Rheinische Friedrich-Wilhelms Universität zu Bonn.
Unfallchirurg. 2000 May;103(5):409-12. doi: 10.1007/s001130050558.
This case presents the history of a 56-year-old patient suffering from low back pain for a period of several weeks. The radiological und histopathological examination showed hints for a spondylodiscitis of the fifth lumbar vertebra. Due to a progressive destruction of the fifth vertebra a ventral stabilisation was performed. Again the histological examination showed the characteristics of an unspecific spodylodiscitis. The last biopsy, taken during the explantation of the fixateur interne showed a high malignant lymphoma. A course of chemotherapy was started following the CHOP-Protocol accompanied by radiotherapy. This case demonstrates that meticulous clinical examination as well as advanced radiological techniques can fail in rare differential diagnosis of spondylodiscitis.
该病例介绍了一位56岁患者，其下背部疼痛数周。影像学和组织病理学检查提示第五腰椎椎体发生了脊椎椎间盘炎。由于第五椎体的进行性破坏，进行了前路稳定手术。组织学检查再次显示为非特异性脊椎椎间盘炎的特征。最后一次活检是在取出内固定器时进行的，结果显示为高度恶性淋巴瘤。按照CHOP方案开始化疗并辅以放疗。该病例表明，在脊椎椎间盘炎罕见的鉴别诊断中，细致的临床检查以及先进的影像学技术可能会出现误诊。
