Case 173

An eighty one-year-old female presented in our hospital for his lumbago for approximately two weeks. The pain increased when she rose up. Physical findings indicated tenderness and hitting pain at the spinous process of the lumbar spine. Laboratory test revealed WBC 3240/mm3, Monocytes 15.5%, RBC 295/mm3, Hemoglobin 9.9 g/dL, LDH 225 U/L (124-222), IgG 1919 mg/dL (861-1747), CEA 1ng/dL, D dimer 3. She received lumbar spine MRI (Fig. 1) and CT (Figs. 2-4).

What is your diagnosis ?

1.　Metastatic bone tumor

2.　Anemia

3.　Mononuclear gammopathy

4.　Osteoporosis

5.　Lumbar spondylitis

answer

2019.12.11