Ichikawa Jiro, Wako Masanori, Kawasaki Tomonori, Ochiai Satoshi, Hagino Tetsuo, Taniguchi Naofumi, Mitsui Kouhei, Onohara Kojiro
Department of Orthopaedic Surgery, Interdisciplinary Graduate School of Medicine, University of Yamanashi, Chuo, Kofu 409-3898, Japan.
Department of Pathology, Saitama Medical University International Medical Center, Hidaka 350-1298, Japan.
Diseases. 2025 May 27;13(6):170. doi: 10.3390/diseases13060170.
BACKGROUND/OBJECTIVES: Pneumatocysts, characterized by gas-filled cavities, are commonly found in the spine and pelvis but are rarely observed in the scapula. In this report, we describe two rare cases of scapular pneumatocysts mimicking bone tumors and exhibiting different image findings.
Case 1. A 47-year-old man who presented with neck pain underwent radiography, followed by magnetic resonance imaging (MRI). MRI showed heterogeneity with low and high signals on fat-suppressed T2-weighted images, suggestive of enchondroma or fibrous dysplasia (FD). However, preoperative computed tomography (CT) revealed gas-filled cavities within the tumor, in continuity with the shoulder joint, confirming the diagnosis of a pneumatocyst.
CASE 2: A 58-year-old woman who presented with neck pain underwent similar examinations to Case 1. MRI showed homogeneity with high signals on fat-suppressed T2-weighted images, leading to a suspicion of solitary bone cysts and FD. Preoperative CT revealed gas-filled cavities within the tumor, but no continuity with the joint, leading to the diagnosis of a pneumatocyst. While the exact etiology of pneumatocysts remains unclear, two potential causes are as follows: (i) gas migration from the joint to the bone, and (ii) gas replacement in cystic tumors. Thus, CT is particularly valuable in confirming the presence of gas-filled cavities and aiding in diagnosis.
This report highlights two extremely rare cases of scapular pneumatocysts, reflecting two potential etiologies. The utility of CT in the diagnosis of pneumatocyst has been clarified.
背景/目的：肺气囊以充满气体的腔为特征，常见于脊柱和骨盆，但在肩胛骨中很少见。在本报告中，我们描述了两例罕见的肩胛骨肺气囊病例，它们酷似骨肿瘤并表现出不同的影像表现。
病例1。一名47岁因颈部疼痛就诊的男性接受了X线检查，随后进行了磁共振成像（MRI）检查。MRI在脂肪抑制T2加权图像上显示出低信号和高信号的异质性，提示内生软骨瘤或骨纤维异常增殖症（FD）。然而，术前计算机断层扫描（CT）显示肿瘤内有充满气体的腔，与肩关节相连，确诊为肺气囊。
病例2：一名58岁因颈部疼痛就诊的女性接受了与病例1类似的检查。MRI在脂肪抑制T2加权图像上显示出高信号的均匀性，怀疑为孤立性骨囊肿和FD。术前CT显示肿瘤内有充满气体的腔，但与关节不相连，诊断为肺气囊。虽然肺气囊的确切病因尚不清楚，但有两个潜在原因如下：（i）气体从关节迁移到骨骼，（ii）囊性肿瘤中的气体替代。因此，CT在确认充满气体的腔的存在并协助诊断方面特别有价值。
本报告突出了两例极其罕见的肩胛骨肺气囊病例，反映了两种潜在病因。CT在肺气囊诊断中的效用已得到阐明。
Zotero 插件
