Wong D A, Fornasier V L, MacNab I
Department of Orthopedic Surgery, University of Toronto, Ontario, Canada.
Spine (Phila Pa 1976). 1990 Jan;15(1):1-4.
Spines from 832 deceased patients with a terminal diagnosis of malignant neoplasm were examined grossly, microscopically and radiographically for evidence of tumor. Gross tumor and bone destruction or sclerosis were reliable signs of obvious metastases. Occult lesions visualized on gross sagittal sections but not detectable radiographically occurred in 26% of spines with confirmed metastatic deposits. Vertebral collapse was not a reliable indicator of metastases. Collapse was not caused by neoplasm in 22% of cases. Overall, metastases were found in 36% of patients dying from neoplastic disease. Although most metastases are obvious, occult lesions not visible radiographically occur. Collapsed vertebra may be impostors simulating metastatic disease.
对832例终末期诊断为恶性肿瘤的已故患者的脊柱进行了大体、显微镜和影像学检查，以寻找肿瘤证据。大体肿瘤以及骨质破坏或硬化是明显转移的可靠迹象。在26%有确诊转移灶的脊柱中，在大体矢状切片上可见但影像学上无法检测到的隐匿性病变。椎体塌陷不是转移的可靠指标。在22%的病例中，塌陷不是由肿瘤引起的。总体而言，在死于肿瘤性疾病的患者中，36%发现有转移。虽然大多数转移是明显的，但也存在影像学上不可见的隐匿性病变。塌陷的椎体可能是模拟转移性疾病的“冒牌货”。
