【双语病例】甲状旁腺功能亢进性棕色瘤

25 10月

Description

A 38-year-old woman with primary hyperparathyroidism with calvarial masses

女性,38岁。原发性甲状旁腺功能亢进伴颅骨肿块。

【双语病例】甲状旁腺功能亢进性棕色瘤

【双语病例】甲状旁腺功能亢进性棕色瘤

【双语病例】甲状旁腺功能亢进性棕色瘤

【双语病例】甲状旁腺功能亢进性棕色瘤

Legends

Axial T2WI (A), coronal T1WI (B), and coronal contrast-enhanced T1WI (C) demonstrate enhancing right frontal and left pterional intradiploic lesions, showing predominantly hypo-isointense signal intensity on T1- and T2-weighted images. Axial CT scan (D) demonstrates expansile, predominantly lytic lesions in the right frontal and left pterional regions. H & E stain demonstrates neoformed bone trabeculae in a fibrous cellular stroma with hemosiderin pigment deposits and a characteristic “tunneling” resorption of trabeculae.

横断位T2WI、冠状位T1WI及冠状位增强T1WI示右侧额部及左侧颞部颅骨内板病变,T1WI、T2WI均呈低信号。横断位CT示右侧额部及左侧颞部颅骨膨胀性、溶骨性病变。

HE染色示:纤维细胞基质内含铁血黄素沉着及新生骨小梁。骨小梁吸收,呈“隧道征”。

【双语病例】甲状旁腺功能亢进性棕色瘤

Brown Tumor of Hyperparathyroidism

甲状旁腺功能亢进性棕色瘤

  • Brown tumors (BT) are reactive osteolytic lesions caused by primary or secondary hyperparathyroidism.

    棕色瘤是原发或继发性甲旁亢引起的反应性溶骨性病变。

  • BT can occur as solitary or multiple lesions. The lesions may appear in any bone but are most frequently found in facial bones and jaws, sternum, pelvis, ribs and femur.

    棕色瘤可单发或多发,可发生于全身所有骨骼,最好发于颅面骨及颌骨、胸骨、骨盆、肋骨、股骨。

Key Diagnostic Features

  • Expansile lytic lesions

    膨胀性溶骨性病变

  • The cortex may be thinned, fractured, or have a partial sclerotic rim.

    骨皮质变薄,可伴有骨折,可见部分硬化边。

  • MR imaging findings are nonspecific and dependent on the relative proportion of tissue components.

    MR图像缺乏特异性,其表现主要依赖于组织成分的相对比例。

  • Hypointensity on T1WI, strong enhancement following contrast administration, and heterogeneous signal intensity on T2WI

    T1WI呈低信号,增强扫描明显强化。T2WI呈混杂信号。

  • T2-shortening effect by hemosiderin and fluid-fluid levels have been described.

    曾有报道瘤内含铁血黄素沉着呈T2WI低信号,并可见液液平。

DDx

  • Metastases

    转移瘤

  • Epidermoid

    表皮样瘤

  • Multiple myeloma

    多发性骨髓瘤

  • Leukemia

    白血病

  • Lymphoma

    淋巴瘤

  • Langerhans cell histiocytosis

    郎格汉斯细胞组织细胞增生症

Rx

Management of hyperparathyroidism and, rarely, surgery

主要治疗甲旁亢,很少采用手术的方法。

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