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中华临床医师杂志(电子版) ›› 2019, Vol. 13 ›› Issue (12) : 955 -958. doi: 10.3877/cma.j.issn.1674-0785.2019.12.017

所属专题: 经典病例 文献

病例报告

以全身多发骨质破坏为首发临床表现的胃癌一例报告并文献复习
张顺鹏1, 吴涛1,(), 薛锋1, 汉英1, 毛东锋1, 潘耀柱1, 王存邦1, 白海1   
  1. 1. 730050 中国人民解放军联勤保障部队第九四〇医院(原兰州军区兰州总医院)全军血液病中心
  • 收稿日期:2019-04-02 出版日期:2019-06-15
  • 通信作者: 吴涛
  • 基金资助:
    甘肃省自然科学基金资助(145RJZA151)

Gastric carcinoma with systemic multiple bone destruction as first manifestation: a case report and literature review

Shunpeng Zhang1, Tao Wu1(), Feng Xue1   

  • Received:2019-04-02 Published:2019-06-15
  • Corresponding author: Tao Wu
引用本文:

张顺鹏, 吴涛, 薛锋, 汉英, 毛东锋, 潘耀柱, 王存邦, 白海. 以全身多发骨质破坏为首发临床表现的胃癌一例报告并文献复习[J]. 中华临床医师杂志(电子版), 2019, 13(12): 955-958.

Shunpeng Zhang, Tao Wu, Feng Xue. Gastric carcinoma with systemic multiple bone destruction as first manifestation: a case report and literature review[J]. Chinese Journal of Clinicians(Electronic Edition), 2019, 13(12): 955-958.

图1 患者胃部PET-CT检查结果 胃角部胃壁增厚放射性摄取异常增高,SUV最大值4.43。胃角周围、大网膜、小网膜囊、肠系膜间隙及腹膜后多发淋巴结放射性摄取异常增高,以大网膜病变为甚,SUV最大值4.19。横结肠局部结节状放射性摄取异常增高灶,SUV最大值8.23。图a、b、c为同一扫描层面,图a为PET扫描显示腹腔多个淋巴结代谢信号增高,箭头所示为该层面腹腔内代谢信号异常增高的淋巴结;图b为增强CT显示出该处淋巴结呈肿大增生影;图c为目标区域PET-CT合成显像;图d为PET显示患者全身多处器官、组织异常高代谢信号影;PET-CT为X射线正电子发射断层扫描
图2 患者骨骼PET-CT结果 胸骨,双侧多发肋骨,脊柱多发椎体及附件,骨盆多发骨骼,四肢带骨(双侧锁骨及肩胛骨)及四肢骨近端(双侧肱骨及股骨近端)多发骨质破坏,放射性摄取异常增高,SUV最大值6.96。CT示所见上述多发骨骼呈虫蚀样溶骨性骨质破坏,脊柱多发椎体骨质增生。图a为矢状位PET-CT扫描;图b为冠状位PET-CT扫描。PET-CT为X射线正电子发射断层扫描
图3 患者胃组织病理 黏膜中见癌组织,呈散在分布。细胞核大深染,细胞呈低分化,明显的病理性核分裂像。图a为HE染色(×50);图b为HE染色(×100)
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