당뇨 환자에서 경막외 농양과의 감별을 요한 원발성 척추 경막외 임파종
Primary Spinal Epidural Lymphoma Mimicking Epidural Abscess in a Diabetic
소속 상세정보
Kim, Se Hoon/김세훈
Lim, Dong Jun/Cho, Tai Hyoung/Chung, Yong Gu/Lee, Hoon Kap/Lee, Ki Chan/Suh, Jung Keun/임동준/조태형/정용구/이훈갑/이기찬/서중근
KMID : 0359820010300030395
Abstract
경막정맥동 혈전증은 다양한 원인을 가진 비교적 드문 질환으로 알려져왔으며 임상양상 및 발현평태가 매우 다양하여 임상적 진단이 쉽지 았았다. 그러나 최근에는 여러 영상진단 방법, 특히 촬영등을 통해 조기 진단이 가능하게되었다. 치료 방법을 결정할 때, 환자의 임상증상과 정맥순환계의 개인간 차이가 매우 중요한 인자중 하나이다. 저자들은 보존적 치료로 좋은 결과를 얻은 2례의 경막정맥동 환자의 특성을 문헌고찰과 함께 보고하는 바이다.
중심 단어: 경막정맥동 혈전증 · 자기공명영상 혈관촬영 · 정맥순화계
Primary spinal epidural lymphoma(SEL), i.e. occurring in the absence of any detectable extraspinal lymphoproliferative disorder, is an unusual cause of spinal cord compression. The authors report a 48-year-old, diabetic woman presented with back pain followed by acute paraparesis and voiding difficulty. She had been treated with acupunctures on her back before admission, and complete blood count showed leukocytosis with neutrophilia and increased erythrocyte sedimentation rate (ESR). Thoracic spine magnetic resonance imaging(MRI) revealed an epidural mass extending from T5 to T8 with compression of the spinal cord. Emergency decompressive laminectomy was performed with a tentative diagnosis of spinal epidural abscess, but a B-cell lymphoma was final pathologic diagnosis. Further staging showed no other sites of lymphoma, and the spinal lesion was treated by chemotherapy and radiotherapy.
The authors stress that primary SEL can mimic spinal epidural abscess(SEA) in the diabetic patient and should be a diagnostic consideration in patients with a syndrome of acute spinal cord compression manifested by a prodrome of back pain and neuroimaging consistent with an epidural compressive lesion, especially in a diabetic.
키워드
Primary spinal epidural lymphoma;Epidural abscess;Spinal cord compression;Diabetic;원발성 척추 경막외 임파종;경막외 농양;척수 압박;당뇨
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