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黄色肉芽肿性骨髓炎:累及胫骨干的罕见病例的多模态影像学表现及文献复习

Xanthogranulomatous osteomyelitis: multimodality imaging of a rare case involving tibial diaphysis with review of literature.

作者信息

Mohanan Shilpa, Bajaj Suryansh, Pasternak Evgeniya, Lobo Rodolfo Henrich, Bajaj Gitanjali

机构信息

Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, AR, 72205, USA.

Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, AR, 72205, USA.

出版信息

Skeletal Radiol. 2025 Jul;54(7):1553-1564. doi: 10.1007/s00256-024-04851-9. Epub 2024 Dec 23.

Abstract

The case report discusses xanthogranulomatous osteomyelitis, a rare inflammatory bone condition that can resemble malignancy on imaging studies. The report details a case of a 42-year-old woman with left leg pain, swelling, and redness lasting 4 months. Imaging revealed a lytic lesion in the left tibia with endosteal erosion, and MRI showed extraosseous soft tissue extension. An open biopsy confirmed xanthogranulomatous osteomyelitis. Following surgical curettage and bone grafting, the patient recovered well at subsequent follow-ups until 1 year after surgery. The article emphasizes the importance of distinguishing xanthogranulomatous osteomyelitis from other malignancies and discusses its epidemiology, clinical presentation, diagnostic techniques, and relevant imaging features, highlighting the potential for misdiagnosis based on overlapping characteristics with conditions like lymphoma and Ewing sarcoma.

摘要

该病例报告讨论了黄色肉芽肿性骨髓炎,这是一种罕见的炎性骨病,在影像学检查中可能类似于恶性肿瘤。报告详细介绍了一名42岁女性的病例,她左腿疼痛、肿胀和发红持续了4个月。影像学检查显示左胫骨有一个溶骨性病变,伴有骨内膜侵蚀,MRI显示有骨外软组织延伸。开放活检证实为黄色肉芽肿性骨髓炎。经过手术刮除和骨移植后,患者在随后的随访中恢复良好,直至术后1年。文章强调了区分黄色肉芽肿性骨髓炎与其他恶性肿瘤的重要性,并讨论了其流行病学、临床表现、诊断技术和相关影像学特征,突出了基于与淋巴瘤和尤因肉瘤等疾病重叠特征而误诊的可能性。

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