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伴有广泛腹腔寒性脓肿的波特病,曾被误诊为恶性肿瘤。

Pott's disease with extensive cold abscess in the abdominal cavity which was misinterpreted as malignancy.

作者信息

Kartika Peranginangin P Deasy, Ferriastuti Widiana

机构信息

Department of Radiology, Faculty of medicine, Universitas Airlangga, Dr. Soetomo General Hospital, Surabaya, Indonesia.

出版信息

Radiol Case Rep. 2022 Mar 3;17(5):1502-1505. doi: 10.1016/j.radcr.2022.01.070. eCollection 2022 May.

DOI:10.1016/j.radcr.2022.01.070
PMID:35265249
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8898755/
Abstract

Pott's disease is a distinctive presentation of tuberculosis that occurs in approximately 5% of extrapulmonary cases that progressively developed a voluminous paravertebral abscess. While the disease is marked only by the occurrence of inflammatory symptoms and low-grade pain, the advanced mimics other infections and malignancies. Therefore, early recognition is important for proper treatment preventing deformity of the residual spinal and permanent neurological deficit. We present a 20-years-old woman who experienced low back pain for 2 years and presented with a right-side lump in the abdomen. CT and MRI were performed in this case. CT image showed bone destruction and extensive abscess formation, while on an MRI there was epidural granulation and compacted cauda equina resulting in severe central canal stenosis. To clarify the diagnosis, a chest radiograph and Mantoux test were performed and the patient was confirmed positive for lung tuberculosis. After antituberculosis drug treatment, (Isoniazid, Rifampicin, Pyrazinamide, and Ethambutol) initial phase, the patient had difficulty walking.

摘要

波特氏病是结核病的一种特殊表现形式,约占肺外结核病例的5%,会逐渐形成大量椎旁脓肿。虽然该病仅表现为炎症症状和轻度疼痛,但晚期症状类似其他感染和恶性肿瘤。因此,早期识别对于正确治疗、预防残留脊柱畸形和永久性神经功能缺损非常重要。我们报告一名20岁女性,她腰痛2年,腹部右侧出现肿块。对该病例进行了CT和MRI检查。CT图像显示骨质破坏和广泛脓肿形成,而MRI显示硬膜外肉芽组织和马尾受压,导致严重的中央管狭窄。为明确诊断,进行了胸部X光片和结核菌素试验,该患者被确诊为肺结核阳性。在抗结核药物治疗(异烟肼、利福平、吡嗪酰胺和乙胺丁醇)的初始阶段,患者行走困难。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/97bb/8898755/da35db2446a4/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/97bb/8898755/b3bdf9a2289f/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/97bb/8898755/fa9dd250a4a0/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/97bb/8898755/5e7b5ad160cb/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/97bb/8898755/da35db2446a4/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/97bb/8898755/b3bdf9a2289f/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/97bb/8898755/fa9dd250a4a0/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/97bb/8898755/5e7b5ad160cb/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/97bb/8898755/da35db2446a4/gr4.jpg

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本文引用的文献

1
Pott's Spine: Diagnostic Imaging Modalities and Technology Advancements.波特氏脊柱病:诊断成像方式与技术进展
N Am J Med Sci. 2013 Jul;5(7):404-11. doi: 10.4103/1947-2714.115775.
2
Spinal tuberculosis: a review.脊柱结核:综述
J Spinal Cord Med. 2011;34(5):440-54. doi: 10.1179/2045772311Y.0000000023.
3
Spinal tuberculosis: CT and MRI feature.脊柱结核:CT与MRI表现
Ann Saudi Med. 2004 Nov-Dec;24(6):437-41. doi: 10.5144/0256-4947.2004.437.