Imaging features of solitary bone plasmacytoma / 白血病·淋巴瘤

ABSTRACT

Objective:To investigate the imaging features of solitary bone plasmacytoma (SBP) and to improve the diagnosis of SBP.Methods:The imaging and clinical data of 8 cases clinically diagnosed as SBP at different sites from September 2012 to September 2020 in Yuanping First People's Hospital of Shanxi Province were retrospectively analyzed. Imaging examinations included CT, magnetic resonance imaging (MRI) plain scan and enhanced MRI scan.Results:The lesion sites of 8 patients included 3 cases of thoracic vertebrae, 2 cases of lumbar vertebrae, 2 cases of skull, and 1 case of rib. Among them, 1 case was misdiagnosed as thoracic metastatic tumor, 1 case as thoracic tuberculosis, 1 case as lumbar lymphoma and 1 case as cranial meningioma. Osteolytic destruction of bone was found in all cases accompanied by expansible changes of bone and soft tissue masses. There were 5 cases of vertebral bodies compressed and flattened; CT showed equal/low density, T1WI showed equal/low signal, T2WI showed low/slightly high signal, and 2 cases showed typical "mini brain sign". There were 2 cases of skull with slight hyperintensity on CT, isointensity on T1WI, and equal/mixed hyperintensity on T2WI. The rib cases showed isodensity on CT, T1WI showed isointensity, T2WI showed slightly high intensity. The lesions of 4 SBP patients showed obvious uniform enhancement on MRI enhanced scan.Conclusions:SBP at different sites can show osteolytic destruction with uniform enhancement of lesions and soft tissue masses. "Mini brain sign" is the SBP-specific imaging sign of the spine.