Martínez-Mata A M, Martínez-Pardavila R, de Arriba-Villamor C, Espinosa-Mogro H
Servicio de Radiodiagnóstico, Hospital San Millán, Logroño, España.
Rev Neurol. 1999;28(8):781-3.
Cerebral gliomatosis (CG) is a diffuse infiltrating glial neoplasia which may affect any part of the central nervous system (CNS). Its diffuse infiltrating growth leads to difficulty with clinical suspicion and imaging technique diagnosis. Magnetic resonance (MR) is more sensitive than computerized tomography (CT) for the detection of lesions. However, the extent of the infiltration may be roughly evaluated using current imaging techniques.
In this article we describe histological aspects of this rare condition, its biological behavior and correlation with radiological findings, and review the contribution of other techniques (positron emission tomography, immunohistochemical examination) in its diagnosis and delimitation.
We present a case of CG in a 26 year old man. On CT no alterations were seen. On MR there was diffuse involvement of the white matter extending to the cortex. The patient worsened rapidly and later developed two focal masses of glioblastoma multiform in areas with the most neoplastic infiltration.
MR is more useful than CT in establishing the diagnosis and extent of CG. Although it is a rare condition, it should be included in the differential diagnosis of conditions which affect the white matter in a diffuse manner. Poor delimitation between white and grey matter helps in diagnosis of this condition.
大脑胶质瘤病（CG）是一种弥漫性浸润性胶质肿瘤，可累及中枢神经系统（CNS）的任何部位。其弥漫性浸润性生长导致临床怀疑和影像技术诊断存在困难。磁共振成像（MR）在检测病变方面比计算机断层扫描（CT）更敏感。然而，目前的成像技术只能大致评估浸润范围。
在本文中，我们描述了这种罕见疾病的组织学特征、生物学行为及其与影像学表现的相关性，并回顾了其他技术（正电子发射断层扫描、免疫组织化学检查）在其诊断和界定中的作用。
我们报告一例26岁男性的大脑胶质瘤病病例。CT检查未见异常。MR检查显示白质弥漫受累并延伸至皮质。患者病情迅速恶化，随后在肿瘤浸润最严重的区域出现两个多形性胶质母细胞瘤局灶性肿块。
在确定大脑胶质瘤病的诊断和范围方面，MR比CT更有用。尽管这是一种罕见疾病，但在以弥漫方式累及白质的疾病鉴别诊断中应考虑到它。白质和灰质之间界限不清有助于诊断此病。
