Department of Pathology, University of Washington, Seattle, WA 98195, USA.
Skeletal Radiol. 2010 Dec;39(12):1245-9. doi: 10.1007/s00256-010-1004-3. Epub 2010 Jul 29.
Disc sequestration is defined as migration of a herniated disc fragment into the epidural space such that it is completely separated from the parent disc. We report a case of a migrated herniated disc that was initially pathologically diagnosed as a cartilage neoplasm. In addition to confounding morphological features, this interpretation may have been influenced by an initial radiological interpretation that did not include herniated disc in the differential diagnosis of a spinal lesion with prominent peripheral contrast enhancement. MR imaging is most helpful in considering other lesions in the differential diagnosis including abscess, hematoma, and primary or metastatic neoplasms. Pathologically, degenerative changes in herniated discs, including clustering of chondrocytes and neovascularization, may be severe resulting in a pseudoneoplastic appearance. Increased awareness of the radiological and pathological features of migrated herniated disc should limit confusion with other tumors.
椎间盘游离是指椎间盘突出的碎片迁移到硬膜外腔,使其与母体椎间盘完全分离。我们报告了一例椎间盘游离的病例,最初的病理诊断为软骨肿瘤。除了形态特征混淆外,这种解释可能还受到最初的影像学解释的影响,该解释在鉴别诊断具有明显外周对比增强的脊柱病变时没有包括椎间盘突出。磁共振成像(MRI)在考虑其他病变的鉴别诊断中最有帮助,包括脓肿、血肿、原发性或转移性肿瘤。病理上,椎间盘突出的退行性改变,包括软骨细胞聚集和新生血管形成,可能很严重,导致假性肿瘤外观。提高对迁移性椎间盘突出的影像学和病理学特征的认识,应有助于减少与其他肿瘤的混淆。