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李某某,男性,58岁。于1991年6月26日因右侧腰腿痛四月入院。入院前二年有无痛血尿史。查:腰_3骶棘突压痛,以腰及椎旁为重,向右下肢放射。AKP正常。X线平片、断层、CT报告:“腰_(4-5)椎旁结核伴冷脓肿。”ECT:“腰_4骶、骨髓炎。”住院期间腰腿痛进行性加重伴出现神经压迫症状、体征。行L_5椎板切除。术中见椎弓烂如腐木。病理报告:“骨和软骨增生。”术后右侧腹部出现包块增大迅速,穿刺活检未见肿瘤。再次CT,诊断:“腰_(4-5)恶性肿瘤。”破坏以后柱为主,B超ECT:“右肾新生物,无功能。”最后诊断:右肾恶性肿瘤伴腰_(4-5)椎弓转移。病人经综合治疗出院,二月后死亡。遗憾二次病理未见肿瘤,死亡后未争取到尸检。
Li Mou, male, 58 years old. On June 26, 1991, he was admitted to hospital in April due to low back pain on the right side. Whether he had a history of painful urine in the first two years before admission. Check: Lumbar spine 3 spinous process tenderness to the waist and paravertebral weight, radiation to the right lower limb. AKP is normal. X-ray, CT, CT report: “Lumbar _ (4-5) paravertebral tuberculosis with cold abscess.” ECT: “waist _4 quack, osteomyelitis.” During hospitalization, low back pain progressively aggravated with the appearance of nerve compression Symptoms and signs. L_5 laminectomy. During the operation, see the vertebral arch rotten as rotten wood. Pathology report: “bone and cartilage hyperplasia.” Postoperative mass in the right abdomen increased rapidly, no biopsy of the tumor. Once again CT, diagnosis: “waist _ (4-5) malignant tumors.” After the destruction of the main column, B-ultrasound ECT: “right kidney neoplasms, no function.” The final diagnosis: right kidney cancer with waist _ (4- 5) Spinal arch transfer. The patient was discharged after comprehensive treatment and died after February. Unfortunately, no tumors were found in the secondary pathology and no autopsy was obtained after death.