Sugiyama Atsuhiko, Ito Shoichi, Sugita Yasumasa, Shimada Jun-Ichiro, Takeuchi Masahiro, Hirano Shigeki, Kuwabara Satoshi
Department of Neurology, Graduate School of Medicine, Chiba University, Japan.
Intern Med. 2015;54(17):2251-3. doi: 10.2169/internalmedicine.54.5095. Epub 2015 Sep 1.
Myeloid sarcoma is a rare hematological disorder that presents as an extramedullary mass of immature myeloid precursors. We herein present the case of a 57-year-old man with a seven-month history of progressive weakness in the right upper extremity. Reconstruction magnetic resonance neurography showed a marked enlargement of the right brachial plexus. Fluorodeoxyglucose positron emission tomography revealed a radioactive lesion in the sacrum, in addition to the right brachial plexus, and a biopsy of the sacrum revealed myeloid sarcoma. The brachial plexus lesion was also regarded as myeloid sarcoma because of the treatment response. Isolated myeloid sarcoma involving the brachial plexus is very rare and its diagnosis is difficult as there was neither a history of leukemia nor bone marrow involvement in this patient. In this case, reconstructed magnetic resonance neurography was useful for detecting the brachial plexus mass lesion which led to an early diagnosis and good recovery.
髓系肉瘤是一种罕见的血液系统疾病,表现为未成熟髓系前体细胞的髓外肿块。我们在此报告一例57岁男性患者,有7个月的右上肢进行性无力病史。重建磁共振神经造影显示右臂丛神经明显增粗。氟脱氧葡萄糖正电子发射断层扫描显示除右臂丛神经外,骶骨有放射性病变,骶骨活检显示为髓系肉瘤。由于治疗反应,臂丛神经病变也被认为是髓系肉瘤。孤立性累及臂丛神经的髓系肉瘤非常罕见,由于该患者既无白血病病史也无骨髓受累,其诊断困难。在本病例中,重建磁共振神经造影有助于检测臂丛神经肿块病变,从而实现早期诊断和良好恢复。