Clarençon Frédéric, Silbermann-Hoffman Olivia, Lebreton Caroline, Fernandez Pédro, Kerrou Khaldoun, Marchand-Adam Sylvain, Hourseau Muriel, Schouman-Claeys Elisabeth, Feydy Antoine
Service de Radiologie, APHP, Hôpital Bichat, Paris, France.
Spine (Phila Pa 1976). 2007 Sep 15;32(20):E594-7. doi: 10.1097/BRS.0b013e31814b86d5.
Case report.
To report 2 cases of sarcoidosis with a diffuse vertebral involvement, associated with a rare location in the sternum.
Sarcoidosis is a systemic disease of unknown cause with various clinical and radiologic manifestations. Bone involvement is rare (1%-13% of cases). Vertebral involvement is very uncommon. Lytic lesions, sclerotic lesions, or both of these patterns may be observed.
One patient complained of diffuse bone pain; the second patient was asymptomatic. Each patient had radiograph, CT, and MRI of the spine. The second patient also underwent a PET/CT FDG-(18F). Sternal bone biopsy was performed in both patients. Pathologic findings indicated typical pattern of bone sarcoidosis. Clinical and biologic improvement was noticed after treatment with corticosteroids.
In our 2 cases, radiograph, CT, MRI, and PET/CT findings were evocative of diffuse spine involvement in sarcoidosis associated with sternal lytic lesions. This suspicion was confirmed by histopathologic findings, which found a typical pattern of sarcoidosis.
These 2 cases emphasize the value of CT, MRI, and FDG-(18F) PET/CT for the diagnosis of diffuse spinal involvement in sarcoidosis and describe an exceptional association with sternal lytic lesions.
病例报告。
报告2例结节病伴弥漫性椎体受累，并伴有胸骨罕见部位受累的病例。
结节病是一种病因不明的全身性疾病，有多种临床和影像学表现。骨骼受累罕见（占病例的1%-13%）。椎体受累非常少见。可观察到溶骨性病变、硬化性病变或这两种病变模式。
1例患者主诉弥漫性骨痛；第2例患者无症状。每位患者均进行了脊柱X线、CT和MRI检查。第2例患者还接受了PET/CT FDG-（18F）检查。两位患者均进行了胸骨活检。病理结果显示为典型的骨结节病模式。使用皮质类固醇治疗后，临床和生物学指标均有改善。
在我们的2例病例中，X线、CT、MRI和PET/CT检查结果提示结节病伴胸骨溶骨性病变的弥漫性脊柱受累。组织病理学结果证实了这一怀疑，发现了典型的结节病模式。
这2例病例强调了CT、MRI和FDG-（18F）PET/CT在诊断结节病弥漫性脊柱受累方面的价值，并描述了与胸骨溶骨性病变的罕见关联。
