胸椎椎板弥漫型腱鞘巨细胞瘤中酷似侵袭性骨病变的骨受累：一例报告
Bone Involvement Mimicking an Aggressive Bone Lesion in a Diffuse-type Tenosynovial Giant Cell Tumor in the Thoracic Vertebral Lamina: A Case Report.
作者信息
Sakamoto Akio, Matsuyama Atsuji, Hisaoka Masanori, Matsuda Shuichi
机构信息
Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Department of Pathology and Oncology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.
出版信息
J Orthop Case Rep. 2018 May-Jun;8(3):14-17. doi: 10.13107/jocr.2250-0685.1088.
INTRODUCTION
Diffuse-type tenosynovial giant cell tumor (D-TGCT), or pigmented villonodular synovitis, is a benign, but aggressive lesion, primarily involving large joints. The spine is rarely affected, with the involvement of the thoracic spine being particularly rare. Massive bone involvement associated with facet joints is a characteristic of spinal D-TGCT.
CASE REPORT
We report the case of a 26-year-old woman with D-TGCT in her first thoracic vertebral lamina. Computed tomography (CT) showed an osteolytic expansive lesion without the involvement of the facet joint. Magnetic resonance imaging (MRI)revealed a lesion with intermediate signal intensity on T1- and T2-weighted images. After computed tomographically guided biopsy, curettage was performed, and D-TGCTwas diagnosed.
CONCLUSIONS
Features of CT and MRI suggested an aggressive bone lesion, and it was challenging to assume D-TGCT, particularly without the involvement of the facet joint.
引言
弥漫型腱鞘巨细胞瘤（D-TGCT），即色素沉着绒毛结节性滑膜炎，是一种良性但具有侵袭性的病变，主要累及大关节。脊柱很少受累，胸椎受累尤为罕见。与小关节相关的大量骨质受累是脊柱D-TGCT的一个特征。
病例报告
我们报告一例26岁女性，其第一胸椎椎板患有D-TGCT。计算机断层扫描（CT）显示为溶骨性膨胀性病变，未累及小关节。磁共振成像（MRI）显示在T1加权和T2加权图像上病变呈中等信号强度。在CT引导下进行活检后，实施了刮除术，并诊断为D-TGCT。
结论
CT和MRI表现提示为侵袭性骨病变，诊断为D-TGCT具有挑战性，尤其是在未累及小关节的情况下。
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