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BMJ Case Reports 2012; doi:10.1136/bcr-03-2012-6121
  • New disease

A kind of specific osteolytic destruction of the vertebral bodies

  1. Yan Hei2
  1. 1Department of Spinal Surgery, General Hospital of Armed Police Force, Beijing, China
  2. 2Department of Pathology, General Hospital of Armed Police Force, Beijing, China
  1. Correspondence to
    Professor Baogan Peng, pengbaogan{at}163.com

Summary

This report describes two young patients with osteolytic destruction in two adjacent vertebral bodies along with the intervertebral disc, and reveals its possible mechanism. A lateral radiograph and CT scan displayed a giant osteolytic cavity in the L4 vertebral body. An MRI or CT scan with a two-dimensional reconstruction displayed the same changes in the L4 vertebral body and lower endplate erosion in the L3 vertebral body. A comprehensive preoperative evaluation did not identify a specific cause of vertebral destruction. Both patients underwent anterior lumbar fusion surgery. The lesions were removed for histological and immunohistochemical examination. Histopathological study of the destructed vertebral bodies in the two patients revealed the disruption or atrophy of bone trabeculae with infiltration of a large amount of B-lymphocytes and macrophages into the marrow cavities. Studies of its pathogenesis reveal that it is likely to be a B-lymphocyte-mediated local immune inflammatory reaction in the lumbar spine.

Footnotes

  • Competing interests None.

  • Patient consent Obtained.

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