Liu Bing, Qu Liyan, Zhu Jian, Yang Zhengming, Yan Shigui
1 Department of Orthopedics, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
2 Clinical Laboratory Centre, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
J Int Med Res. 2017 Aug;45(4):1440-1446. doi: 10.1177/0300060517708530. Epub 2017 Jun 12.
Histoplasmosis is an infection caused by a fungus called Histoplasma. Diagnosis of histoplasmosis is based on the culture of biological samples and detection of fungus in tissues. Histoplasmosis can mimic malignant lesions. We report a 65-year-old, immunocompetent, male patient with back pain. We describe the main clinical and radiological characteristics in our patient who had vertebral histoplasmosis that mimicked cancer. A computed tomography scan showed lytic lesions of the right side of T4, T5, and T6 vertebral bodies. Magnetic resonance imaging displayed abnormal marrow signals in T4, T5, and T6 vertebral bodies (low signal on T1, high on T2 and short time inversion recovery (STIR)). Which was mimicking malignancy, such as haematological malignancy and metastatic bone cancer. Therefore, thoracic spinal surgery using the anterior approach was performed. An intraoperative frozen section examination and routine postoperative pathology showed thoracic histoplasmosis infection. Treatment of histoplasmosis was performed with oral itraconazole. The lesions did not progress and the patient symptomatically improved at a follow-up of 26 months.
组织胞浆菌病是一种由名为荚膜组织胞浆菌的真菌引起的感染。组织胞浆菌病的诊断基于生物样本的培养以及组织中真菌的检测。组织胞浆菌病可类似恶性病变。我们报告一例65岁、免疫功能正常的男性背痛患者。我们描述了我们这位患有类似癌症的脊椎组织胞浆菌病患者的主要临床和放射学特征。计算机断层扫描显示T4、T5和T6椎体右侧的溶骨性病变。磁共振成像显示T4、T5和T6椎体骨髓信号异常（T1加权像呈低信号，T2加权像和短反转恢复序列（STIR）呈高信号），这类似恶性肿瘤，如血液系统恶性肿瘤和转移性骨癌。因此，采用前路进行了胸椎手术。术中冰冻切片检查及术后常规病理显示为胸椎组织胞浆菌感染。采用口服伊曲康唑治疗组织胞浆菌病。在26个月的随访中，病变未进展，患者症状改善。
