Nodular Pseudogout of the Skull Base Arising From the Temporomandibular Joint
Nodular Pseudogout of the Skull Base Arising From the Temporomandibular Joint
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DOI：
10.1097/scs.0000000000007437
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发表时间：
2021-07-01
影响因子：
0.9
通讯作者：
Uchiyama, Taku
中科院分区：
文献类型：
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作者：
Morita, Yuhei;Yamamoto, Naoto;Uchiyama, Taku
作者报告一例罕见的，大，结节性假性痛风，从颞下颌关节（TMJ）发展。一名83岁的女性因左脸颊肿胀被送往医院。影像学检查显示左下颌骨髁周围有一个大的钙化肿块，部分破坏了相邻的骨骼并延伸到颅底。磁共振成像（MRI）显示软组织肿块，T1和T2加权像上呈低信号，静脉注射钆后增强。临床和影像学上怀疑肿块是肿瘤性病变，如软骨肉瘤或纤维结构不良。然而，组织学分析显示，肿块包含肉芽肿性病变，并有大量多发性结节状杆状和菱形晶体沉积，这证实了假性痛风的诊断。进行X射线衍射（XRD）以识别肿瘤的沉积材料，并显示这些是焦磷酸钙二水合物（CPPD）晶体。这一结果证实了“痛风石样假痛风”的组织病理学诊断。"
The authors report a case of a rare, large, nodular pseudogout which developed from the temporomandibular joint (TMJ). An 83-year-old female was referred to the hospital with swelling on her left cheek. Imaging studies revealed a large calcified mass surrounding the left mandibular condyle, partially destroying the adjoining bone and extending to the skull base. Magnetic resonance imaging (MRI) revealed soft tissue masses with low signal intensity on T1- and T2-weighted images and were enhanced after intravenous gadolinium injection. The mass was clinically and radiologically suspected to be a neoplastic lesion, such as chondrosarcoma or fibrous dysplasia. However, histological analysis showed that the mass contained granulomatous lesions with numerous multiple nodular rod-shaped and diamond-shaped crystal deposits, which validated the diagnosis of pseudogout. X-ray diffraction (XRD) was performed to identify the tumor's deposited materials and revealed that these were calcium pyrophosphate dihydrate (CPPD) crystals. This result confirmed the histopathological diagnosis of "tophaceous pseudogout."