Bedford Hospital NHS Trust, Bedford, UK.
J Endovasc Ther. 2012 Aug;19(4):565-7. doi: 10.1583/11-3444R.1.
To report a rare case of myeloid sarcoma infiltration of an aortic stent-graft causing chronic hemorrhage and mimicking stent-graft infection.
A 90-year-old man presented 8 years after endovascular aneurysm repair with general malaise, nausea, abdominal pain, and hyperbilirubinemia. His inflammatory blood markers were elevated, and an abdominal computed tomography (CT) scan showed unusual fluid and soft tissue collection around the stent-graft. A presumptive diagnosis of stent-graft infection was made, and he was started on intravenous antibiotics because he was not fit for surgery. His condition gradually deteriorated in hospital. Four months later he died of sudden hemodynamic collapse and shock. Postmortem examination revealed large malignant periaortic lymphadenopathy with suggestion of stent-graft infiltration and chronic hemorrhage. Histology of the lymph nodes confirmed myeloid sarcoma.
Soft tissue and fluid collections around an aortic stent-graft on CT are not always indicative of a graft infection; malignant tumors, although rare, should be considered.
报告一例罕见的骨髓肉瘤浸润主动脉支架移植物导致慢性出血并模拟支架移植物感染的病例。
一名 90 岁男性在血管内动脉瘤修复术后 8 年出现全身不适、恶心、腹痛和高胆红素血症。他的炎症血液标志物升高，腹部 CT 扫描显示支架周围有异常的液体和软组织积聚。诊断为支架感染，并因不适合手术而开始静脉注射抗生素。他在医院的病情逐渐恶化。四个月后，他因突然血流动力学崩溃和休克而死亡。尸检显示大的恶性主动脉旁淋巴结病，提示支架移植物浸润和慢性出血。淋巴结的组织学证实为骨髓肉瘤。
CT 上主动脉支架周围的软组织和液体积聚并不总是提示移植物感染；虽然罕见，但应考虑恶性肿瘤。
