Bel-Ange Anat, Tal Sigal, Rapoport Micha
Department of Internal Medicine "C", Assaf Harofeh Medical Center, affiliated to Sackler Medical School, Tel Aviv University, Zerifin, Israel.
Department of Radiology, Assaf Harofeh Medical Center, affiliated to Sackler Medical School, Tel Aviv University, Zerifin, Israel.
Eur J Case Rep Intern Med. 2018 Aug 28;5(8):00907. doi: 10.12890/2018_00907. eCollection 2018.
Sarcoidosis is a systemic disorder that most commonly affects the lungs. Bone involvement is rare, and spinal involvement is even more rare. The presence of focal lesions of the vertebrae is highly suspicious of advanced malignancy. However, malignant metastatic spread to the spine involves the vertebral cortex rather than the bone marrow itself, a distinction that is often missed and therefore misleading. We describe here a middle-aged woman with multiple focal oedematous lesions of the bone marrow suspected of being advanced malignancy but finally diagnosed as a rare case of spinal sarcoidosis.
This article describes a rare case of vertebral sarcoidosis.It emphasizes the often-missed distinction between bone marrow and cortical lesions in the diagnostic work-up of focal spinal lesions.It also underscores the combined use of MRI together with FDG/PET-CT in elucidating the nature of lesions confined to the bone marrow.
结节病是一种全身性疾病,最常累及肺部。骨骼受累罕见,脊柱受累更为罕见。椎体局灶性病变高度怀疑为晚期恶性肿瘤。然而,恶性肿瘤转移至脊柱累及椎体皮质而非骨髓本身,这一区别常被忽视,因此具有误导性。我们在此描述一名中年女性,其骨髓有多处局灶性水肿性病变,最初怀疑为晚期恶性肿瘤,但最终诊断为罕见的脊柱结节病病例。
本文描述了一例罕见的椎体结节病病例。强调在局灶性脊柱病变的诊断检查中,骨髓病变与皮质病变之间常被忽视的区别。还强调了联合使用MRI和FDG/PET-CT来阐明局限于骨髓的病变性质。