From the *Department of Nuclear Medicine, General Hospital of Ningxia Medical University, Yinchuan, Ningxia; and Departments of †Nuclear Medicine, ‡Orthopaedic Surgery, and §Pathology, Changhai Hospital, Second Military Medical University, Shanghai, China.
Clin Nucl Med. 2017 Dec;42(12):958-961. doi: 10.1097/RLU.0000000000001872.
A 49-year-old woman complained of right upper back pain for 1 month. Serum tests showed increased erythrocyte sedimentation rate. Thoracic spinal MRI showed an epidural lesion at the T1-T4 level with inhomogeneous signal intensity on T2-weighted images, slightly higher signal intensity than spinal cord on T1-weighted images, and remarkable enhancement on enhanced T1-weighted images. Epidural malignant tumor was suspected. FDG PET/CT was performed showing increased FDG uptake of the lesion extending to the right T1-T2 and T2-T3 neural foramina. A decompressive posterior thoracic laminectomy with the lesion resection was performed. Immunoglobulin G4-related spinal hypertrophic pachymeningitis was confirmed by pathology.
一位 49 岁女性因右上背痛 1 个月就诊。血清学检查示红细胞沉降率升高。胸椎 MRI 显示 T1-T4 水平硬膜外病变，T2 加权像信号不均匀，T1 加权像上信号强度略高于脊髓，增强 T1 加权像上明显强化。考虑硬膜外恶性肿瘤。行 FDG PET/CT 检查示病变摄取 FDG 增加，延伸至右侧 T1-T2 和 T2-T3 椎间孔。行后路胸椎椎板减压加病变切除术。病理证实为 IgG4 相关的脊髓肥厚性硬脑膜炎。
