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散布的Cryptococcus感染呈现为性骨病变,表明骨转移性疾病
Caleb M Yeung1, Nicola Fabbri2
1Department of Surgery, Orthopaedic Service, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, H-10, New York, NY, 10065, USA.
Skeletal radiology
|September 25, 2023
概括
散布的骨密码球菌病可以模仿患有沙尔科病的患者的转移性癌症. 早期诊断需要高度怀疑骨病变中的真菌感染,即使没有典型的危险因素.
科学领域:
- 医学真菌学 医学真菌学
- 骨辐射学 骨辐射学
- 传染性疾病 传染性疾病
背景情况:
- 沙尔科病是一个可以影响多个器官的炎症性疾病.
- 扩散型加密球菌病通常会影响严重免疫性受损的个体.
- 骨参与密码球菌病是罕见的,可以模仿其他病理.
研究的目的:
- 报告一个传播的骨密码球菌病例,模仿转移性癌症.
- 突出免疫功能低下患者的诊断挑战.
- 强调在骨损伤中考虑真菌感染的重要性.
主要方法:
- 一个76岁的男性患有沙尔科毒症和膝盖疼痛的案例介绍.
- 怀疑转移性疾病的初始成像 (MRI) 和分期 (FDG PET/CT).
- 骨损伤的开放活检和微生物学培养.
主要成果:
- 图像检查显示,大腿骨和骨中出现了激进的形骨病变.
- FDG PET/CT显示高代谢性病变和淋巴腺病变,暗示恶性瘤.
- 活检文化确定了Cryptococcus neoformans,揭示了扩散的骨密码菌病.
- 这名患者患有沙尔科发症,这是传播性加密球菌病的非典型危险因素.
结论:
- 散布的骨密码球菌病可以呈现为转移性癌症.
- 怀疑的高指数对于诊断免疫受损患者的骨真菌感染至关重要,包括那些患有沙尔科病的患者.
- 这一案例强调了对无法解释的骨损伤进行彻底的诊断评估的需要.
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