Ahmed Mohamed H, Joshi Shravani, Heidari Amirmohammad, Pearce Oliver, Panourgia Maria, Owles Henry, Dungarwalla Moez
Department of Medicine and HIV Metabolic Clinic, Milton Keynes University Hospital NHS Foundation Trust, Eaglestone, Milton Keynes, Buckinghamshire, UK.
Department of Geriatric Medicine, Milton Keynes University Hospital NHS Foundation Trust, Eaglestone, Milton Keynes, Buckinghamshire, UK.
J Med Cases. 2023 Mar;14(3):95-99. doi: 10.14740/jmc4055. Epub 2023 Mar 31.
We report a case of a 65-year-old woman who sustained a left neck of femur (NOF) fracture following low-energy trauma. Computed tomography (CT) scan for the neck, chest, abdomen and pelvis was normal apart from enlargement of the right lobe of the thyroid. Interestingly, thyroid function was normal. While waiting for the result of thyroid cytology and bone histology, the patient recovered well from the operation and started to engage well with physiotherapy. The result of the investigation showed presence of diffuse large B-cell lymphoma in the left NOF and right lobe of the thyroid. As the presence of lymphoma only in these two organs is extremely rare, it is not yet clear what is underlying mechanism for such association. Therefore, such observations may raise many future research questions as detailed in the discussion of this case report. This case also illustrates the importance of a multidisciplinary approach in identifying, evaluating, and treating unique and complex presentations of NOF fracture, with a focus on the patient's history, clinical examination and applying diagnostic tools.
我们报告一例65岁女性，她在低能量创伤后发生左侧股骨颈（NOF）骨折。颈部、胸部、腹部和骨盆的计算机断层扫描（CT）除甲状腺右叶肿大外均正常。有趣的是，甲状腺功能正常。在等待甲状腺细胞学和骨组织学结果期间，患者术后恢复良好，并开始积极配合物理治疗。检查结果显示左侧NOF和甲状腺右叶存在弥漫性大B细胞淋巴瘤。由于仅在这两个器官中出现淋巴瘤极为罕见，目前尚不清楚这种关联的潜在机制是什么。因此，如本病例报告讨论中所详述，此类观察结果可能会引发许多未来的研究问题。该病例还说明了多学科方法在识别、评估和治疗NOF骨折独特而复杂的表现方面的重要性，重点关注患者病史、临床检查并应用诊断工具。
