Gmeinwieser J, Gullotta U, Reiser M, Saida Y, Mack D
Rofo. 1982 Jul;137(1):68-72. doi: 10.1055/s-2008-1056160.
The radiological due to extensive extramedullary haematopoiesis taking place in the posterior mediastinum in two patients are described, and the literature is reviewed. Characteristic features are a polycyclic or spindle-shaped configuration of the mass, with bilateral paravertebral localisation in the caudal and middle third of the thorax. There is absence of inflammatory or neoplastic changes in the neighbouring skeleton, but in thalassaemia there may be changes in the paravertebral portion of the ribs. Computer tomographically, the combination of a solid paravertebral tumour, with adjacent rib changes, is characteristic of thalassaemia with extramedullary haematopoiesis. In the absence of other skeletal changes, computed tomography is valuable for differential diagnosis. Lymphomas occur considerably more often and may appear identical but, because of the well know fat content of myolipoma, the scan shows contrast values between -15 and + 40 HU. Because of their high vascularity, there is a marked increase in density following intravenous contrast medium.
本文描述了两名患者后纵隔广泛髓外造血的影像学表现,并对相关文献进行了综述。其特征性表现为肿块呈多环状或梭形,位于胸部下三分之一和中三分之一的双侧椎旁。相邻骨骼无炎症或肿瘤性改变,但地中海贫血患者肋骨的椎旁部分可能有变化。计算机断层扫描显示,实性椎旁肿瘤合并相邻肋骨改变是地中海贫血伴髓外造血的特征。在无其他骨骼改变的情况下,计算机断层扫描对鉴别诊断有重要价值。淋巴瘤更为常见,表现可能相似,但由于错构瘤脂肪含量已知,扫描显示其密度值在-15至+40 HU之间。由于其血管丰富,静脉注射造影剂后密度显著增加。