英文摘要 |
A 74-year-old male patient presented with pain and stiffiness of the low back and left hip of one week's duration. About 14 months previously, he had a right posterior cervical lymphadenopathy and non-Hodgkin's lymphoma (NHL) was proved pathologically. He received 6 courses of chemotherapy and went into clinical remission. A radiograph of the left pelvic bone showed intact bony structures. A bone scan revealed left sacroiliitis. Magnetic resonance imaging (MRI) of the pelvic bone showed an intraosseous lesion of the whole left iliac bone, partially involving LI-5, and extraosseous masses involving the left gluteus minimus, iliacus and pirformis muscles with low T1-weighted signal intensity and high T2-weighted signal intensity. However, the bony cortex remained relatively intact. NHL was subsequenty proved by bone marrow biopsy of the left iliac bone. He was given chemotherapy which consisted of prednisolone, oncovin and cyclophosphamide. However, his condition deteriorated rapidly 10 days later and he died of Pseudomonas septicemia. Rheumatic signs and symptoms may be the presenting paraneoplastic features of underlying lymphoproliferative diseases. MRI may provide a very early diagnosis of the disease. |