Renjen Pooja, Kovanlikaya Arzu, Narula Navneet, Brill Paula W
Department of Radiology, New York Presbyterian Hospital/Weill Cornell Medical Center, 525 East 68th Street, New York, NY, 10065, USA.
Skeletal Radiol. 2014 Nov;43(11):1633-8. doi: 10.1007/s00256-014-1935-1. Epub 2014 Jun 21.
A 9-year-old boy presented with the sudden onset of pleuritic chest pain and on CT was found to have a large pleural effusion, mediastinal fluid, splenic lesions and multiple apparently sclerotic vertebral bodies. Subsequent MRI showed that those vertebral bodies that appeared sclerotic were in fact normal, and the vertebral bodies initially interpreted as normal had an abnormal T1 and T2 hyperintense signal on MRI and were relatively lucent on CT. MRI also demonstrated abnormal heterogeneous T2 hyperintense paraspinal tissue and several multicystic soft tissue masses. Biopsy of two adjacent vertebral bodies, one relatively sclerotic and one lucent, demonstrated findings of bony remodeling without a specific diagnosis. Biopsy of an infiltrative mediastinal mass confirmed the diagnosis of generalized cystic lymphangiomatosis. MRI should be included in the assessment of vertebral involvement in this condition because CT and biopsy findings may be nonspecific.
一名9岁男孩突然出现胸膜炎性胸痛，CT检查发现有大量胸腔积液、纵隔积液、脾脏病变以及多个明显硬化的椎体。随后的MRI显示，那些看似硬化的椎体实际上是正常的，而最初被认为正常的椎体在MRI上有异常的T1和T2高信号，在CT上相对透亮。MRI还显示椎旁组织有异常的不均匀T2高信号以及几个多囊性软组织肿块。对两个相邻椎体进行活检，一个相对硬化，一个透亮，结果显示为骨质重塑，但未明确诊断。对一个浸润性纵隔肿块进行活检，确诊为全身性囊性淋巴管瘤病。对于这种疾病的椎体受累情况评估应包括MRI检查，因为CT和活检结果可能不具有特异性。
