Lombardi Rosa, Pelusi Serena, Airaghi Lorena, Fargion Silvia
Department of Internal Medicine, Ospedale Maggiore Policlinico Regina Elena Milano, Milan, Italy.
BMJ Case Rep. 2015 May 6;2015:bcr2014207146. doi: 10.1136/bcr-2014-207146.
A 50-year-old Brazilian woman was admitted to our department because of pelvic pain irradiated to the lower left limb, ipsilateral ankle swelling and progressive weight loss. Doppler ultrasound demonstrated deep venous femoropopliteal thrombosis, while a thorax-abdomen CT scan showed multiple solid hypodense pulmonary lesions, a large hypodense lesion in the iliopsoas muscles bilaterally and a complex cystoid lesion at the hepatic hilum. These findings were better characterised as active inflammatory colliquated lymph nodes by positron emission tomography and echo-guided percutaneous fine-needle aspiration of the left iliopsoas abscessual lesion finally allowed the diagnosis of tubercular infection with positive cultures for Mycobacterium tuberculosis complex.
一名50岁的巴西女性因骨盆疼痛放射至左下肢、同侧踝关节肿胀和进行性体重减轻而入住我科。多普勒超声显示股腘深静脉血栓形成,而胸腹CT扫描显示多个实性低密度肺病变、双侧髂腰肌内一个大的低密度病变以及肝门处一个复杂的囊样病变。正电子发射断层扫描将这些发现更好地定性为活动性炎性液化淋巴结,对左髂腰肌脓肿病变进行超声引导下经皮细针穿刺,最终诊断为结核感染,结核分枝杆菌复合群培养阳性。