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肌肉骨骼系统副球孢子菌病的计算机断层扫描结果

Computed tomography findings of paracoccidiodomycosis in musculoskeletal system.

作者信息

Lima Júnior Francisco Valtenor Araújo, Savarese Leonor Garbin, Monsignore Lucas Moretti, Martinez Roberto, Nogueira-Barbosa Marcello Henrique

机构信息

MDs, Residents of Radiology and Imaging Diagnosis, Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (HCFMRPUSP), Ribeirão Preto, SP, Brazil.

Physician Assistant at Centro de Ciências das Imagens e Física Médica (CCIFM) da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (FMRPUSP), Ribeirão Preto, SP, Brazil.

出版信息

Radiol Bras. 2015 Jan-Feb;48(1):1-6. doi: 10.1590/0100-3984.2014.0049.

Abstract

OBJECTIVE

To evaluate musculoskeletal involvement in paracoccidioidomycosis at computed tomography.

MATERIALS AND METHODS

Development of a retrospective study based on a review of radiologic and pathologic reports in the institution database. Patients with histopathologically confirmed musculoskeletal paracoccidioidomycosis and submitted to computed tomography were included in the present study. The imaging findings were consensually described by two radiologists. In order to avoid bias in the analysis, one patient with uncountable bone lesions was excluded from the study.

RESULTS

A total of seven patients were included in the present study. A total of 18 bone lesions were counted. The study group consisted of 7 patients. A total number of 18 bone lesions were counted. Osteoarticular lesions were the first manifestation of the disease in four patients (57.14%). Bone lesions were multiple in 42.85% of patients. Appendicular and axial skeleton were affected in 85.71% and 42.85% of cases, respectively. Bone involvement was characterized by well-demarcated osteolytic lesions. Marginal osteosclerosis was identified in 72.22% of the lesions, while lamellar periosteal reaction and soft tissue component were present in 5.55% of them. One patient showed multiple small lesions with bone sequestra.

CONCLUSION

Paracoccidioidomycosis can be included in the differential diagnosis of either single or multiple osteolytic lesions in young patients even in the absence of a previous diagnosis of pulmonary or visceral paracoccidioidomycosis.

摘要

目的

通过计算机断层扫描评估副球孢子菌病的肌肉骨骼受累情况。

材料与方法

基于对机构数据库中放射学和病理学报告的回顾开展一项回顾性研究。本研究纳入经组织病理学确诊为肌肉骨骼副球孢子菌病并接受计算机断层扫描的患者。影像学表现由两名放射科医生共同描述。为避免分析中的偏倚,一名有无法计数骨病变的患者被排除在研究之外。

结果

本研究共纳入7例患者。共计数18处骨病变。研究组由7例患者组成。共计数18处骨病变。骨关节病变是4例患者(57.14%)疾病的首发表现。42.85%的患者骨病变为多发。分别有85.71%和42.85%的病例累及四肢骨骼和中轴骨骼。骨受累表现为边界清晰的溶骨性病变。72.22%的病变可见边缘骨硬化,5.55%的病变可见层状骨膜反应和软组织成分。1例患者表现为多发小病变伴骨质死骨。

结论

即使在既往无肺部或内脏副球孢子菌病诊断的情况下,副球孢子菌病也可纳入年轻患者单发或多发溶骨性病变的鉴别诊断。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d8f/4366020/7ad4e6e45b46/rb-48-01-0001-g01.jpg

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