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患者男,64岁。左下肢无力20余天,加重伴尿便障碍10d。神经查体:左下肢肌力Ⅲ级,左下肢皮肤痛温觉减退。胸椎MRI示:胸8椎体水平脊髓内占位性病变。实验室检查:RPR和TPPA(+)。患者经手术切除脊髓病变,病理报告:增生的纤维及炎性肉芽组织,可见大量浆细胞浸润。诊断:脊髓内树胶样肿。予水剂青霉素G,2 400万U/d分6次给药,治疗14d。3个月后随诊RPR滴度下降。现患者仍在随诊中。
Patient male, 64 years old. Left lower extremity weakness more than 20 days, aggravated with urinary tract obstruction 10d. Neurological examination: left lower extremity muscle strength Ⅲ, left lower extremity skin pain hypoglycemia. Thoracic MRI showed: chest 8 vertebral level spinal lesions. Laboratory tests: RPR and TPPA (+). Patients underwent surgical removal of myelopathy, pathological reports: hyperplastic fibrosis and inflammatory granulation tissue, showing a large number of plasma cell infiltration. Diagnosis: Spinal gum swollen. Preservative penicillin G, 24 million U / d administered 6 times for 14 days. RPR titers dropped after 3 months. Patients are still under follow-up.