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结节病累及脊柱伴胸骨溶骨性病变:两例病例报告

Diffuse spine involvement in sarcoidosis with sternal lytic lesions: two case reports.

作者信息

Clarençon Frédéric, Silbermann-Hoffman Olivia, Lebreton Caroline, Fernandez Pédro, Kerrou Khaldoun, Marchand-Adam Sylvain, Hourseau Muriel, Schouman-Claeys Elisabeth, Feydy Antoine

机构信息

Service de Radiologie, APHP, Hôpital Bichat, Paris, France.

出版信息

Spine (Phila Pa 1976). 2007 Sep 15;32(20):E594-7. doi: 10.1097/BRS.0b013e31814b86d5.

Abstract

STUDY DESIGN

Case report.

OBJECTIVE

To report 2 cases of sarcoidosis with a diffuse vertebral involvement, associated with a rare location in the sternum.

SUMMARY OF BACKGROUND DATA

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.

METHODS

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.

RESULTS

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.

CONCLUSION

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.

摘要

研究设计

病例报告。

目的

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。

背景资料总结

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。

方法

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。

结果

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。

结论

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。

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