Beckers C, Foidart J, Thiry A, Malaise M G
Département de Médecine Interne, Service de Médecine Nucléaire, CHU Sart Tilman.
Rev Med Liege. 2002 Jul;57(7):467-74.
A case of carcinomatous monoarthritis involving the left knee due to colonic adenocarcinoma is described. Large recurrent synovial effusion, that will be later hematic, lytic lesion of the bones and chondrolysis were noted. Knee positron emitting tomography scan using FDG (FDG-PET) revealed a diffuse increased uptake in soft tissues assumed to be synovium, the hypertrophy of which was identified by ultrasonography. Whole body PET scan showed extensive lymph node, visceral and bone metastases, suggesting that the increase in the synovium could also be of metastatic origin. The final diagnosis of synovial carcinomatosis secondary to the known colonic adenocarcinoma was confirmed by histological analysis of biopsies obtained by arthroscopy. A review of the literature is realised. To our knowledge, this is the first synovial metastasis studied by FDG-PET.
本文描述了一例因结肠腺癌导致左膝关节癌性单关节炎的病例。观察到大量反复出现的滑膜积液,后期积液呈血性,同时存在骨质溶解病变和软骨溶解。使用氟代脱氧葡萄糖(FDG)的膝关节正电子发射断层扫描(FDG-PET)显示,假定为滑膜的软组织中有弥漫性摄取增加,超声检查确定了滑膜肥大。全身PET扫描显示广泛的淋巴结、内脏和骨转移,提示滑膜增生也可能源于转移。通过关节镜活检的组织学分析,证实了已知结肠腺癌继发滑膜癌病的最终诊断。我们进行了文献综述。据我们所知,这是首例通过FDG-PET研究的滑膜转移病例。