La Localizzazione Vertebrale Del Granuloma Maligno E La Sua Diagnosi Differenziale

Abstract

Basing on 4 personal cases, the radiological pictures of the vertebral localizations of malignant granuloma are illustrated in comparison with other more common vertebral diseases. The following roentgenographical characteristics have been observed: polymorphism, consequent to the frequent concomitance of sclerotic lesions; monostotic nature, expecially at the level of the vertebral body; prevalence of marginal erosive alterations on periostal ones; frequent involvement of the disk which is never completely destroyed; rare neoformations of thin osteophitic bridges. However, being the early diagnosis histologically difficult in case of primary vertebral localization and occasionally hard to obtain even with X-rays investigation, the ascertainment has to be based on a clinical criterion. Data of particular value are: 1) the presence of a painful neurological symptomatology of neuralgic-neuritic type only responsive to X-rays therapy, with trophic and motorial lesions and with impairment of the reflected and sphinteric activity; 2) very high erythrocyte sedimentation rate, marked eosinophilia and tuberculin anergy. The occurrence (although unfrequent) of a primary and temporarily unique vertebral localization justifies the roentgentherapy with ex juvantibus diagnostical criterion.