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胸椎椎管内支气管源性囊肿合并慢性粒细胞白血病。

Combination of a bronchogenic cyst in the thoracic spinal canal with chronic myelocytic leukemia.

作者信息

Zhang Hao, Li Hai-Feng, Duan Hai-Feng, Huang Ke-Feng, Tian Zhi-Hua

机构信息

Department of Neurosurgery, Jin Cheng People's Hospital, No. 1666 Baishui East Street, Jincheng, Shanxi 048026, China.

出版信息

Open Life Sci. 2023 Sep 30;18(1):20220736. doi: 10.1515/biol-2022-0736. eCollection 2023.

Abstract

The presented case report describes an incredibly rare instance of an intramedullary bronchial cyst located in the thoracic spinal canal on the dorsal side of the spinal cord, which was observed in a patient with chronic myelogenous leukemia. A 29-year-old man presented with back pain for half a month, along with numbness and pain below the chest and ribs for 1 week. Hypersensitivity was present in the inferior plane of the long xiphoid process in the nervous system. Magnetic resonance imaging (MRI) showed intramedullary cystic lesions in the vertebral body plane of the third to the fourth thoracic vertebra. There was no recurrence during the 6-month postoperative follow-up period. The histopathological findings were consistent with bronchogenic cysts. Cystic lesions were eliminated through the posterior median approach. After the cyst ruptured during surgery, gel liquid was seen, and the majority of the cyst walls were removed. One week after the surgery, the hypersensitivity fully subsided. Six months following surgery, an updated MRI revealed no recurrence. Intramedullary bronchogenic cysts on the dorsal side of the thoracic spine are extremely uncommon. Diagnosis requires histopathological evidence, and it is challenging to diagnose before surgery. Prompt surgical resection is recommended in case of positive diagnosis.

摘要

本病例报告描述了一例极为罕见的位于胸段椎管脊髓背侧的髓内支气管囊肿,该病例发生在一名慢性粒细胞白血病患者身上。一名29岁男性,出现背痛半个月,同时伴有胸部及肋骨以下麻木和疼痛1周。神经系统检查发现剑突下平面感觉过敏。磁共振成像(MRI)显示胸3至胸4椎体平面髓内囊性病变。术后6个月随访期间无复发。组织病理学检查结果与支气管源性囊肿相符。通过后正中入路切除囊性病变。手术过程中囊肿破裂后可见胶冻样液体,大部分囊壁被切除。术后1周,感觉过敏完全消退。术后6个月,复查MRI未见复发。胸段脊柱背侧的髓内支气管源性囊肿极为罕见。诊断需要组织病理学证据,术前诊断具有挑战性。确诊后建议及时手术切除。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d4f7/10543701/34a13d30deed/j_biol-2022-0736-fig001.jpg

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