Wolff R, Zimmermann M, Marquardt Gerhard, Lanfermann H, Nafe R, Seifert V
Neurosurgical Clinic, Johann Wolfgang Goethe University, Frankfurt am Main, Germany.
Acta Neurochir (Wien). 2002 Sep;144(9):941-4; discussion 944-5. doi: 10.1007/s00701-002-0968-8.
Glioblastoma of the brain stem is rare and there is no description of such a lesion in patients suffering from acquired immunodeficiency syndrome. The majority of intracerebral mass lesions are due either to toxoplasmosis or primary central nervous system lymphomas so that it is usually not included in the differential diagnosis of enhancing lesions of the central nervous system in these patients. A 31-year-old human immunodeficiency virus (HIV) infected man presented with a four months history of slowly progressive deterioration of brainstem associated symptoms despite antitoxoplasmic therapy. Magnetic resonance imaging revealed a large ring enhancing lesion in the brainstem. Clinical and neuroradiological data could not establish a proper diagnosis and a stereotactic serial biopsy was undertaken. Histological examination of the specimen showed a glioblastoma multiforme (GBM) as the first reported case of GBM located in the brainstem in an acquired immunodeficiency syndrome (AIDS) patient. Patient management and effectiveness of stereotactic serial biopsy are discussed.
脑干胶质母细胞瘤较为罕见，在获得性免疫缺陷综合征患者中尚无此类病变的描述。大多数脑内肿块病变要么是由弓形虫病引起，要么是原发性中枢神经系统淋巴瘤所致，因此在这些患者中，它通常不被纳入中枢神经系统强化病变的鉴别诊断。一名31岁的人类免疫缺陷病毒（HIV）感染男性，尽管接受了抗弓形虫治疗，但仍有四个月的脑干相关症状缓慢进展恶化病史。磁共振成像显示脑干有一个大的环形强化病变。临床和神经放射学数据无法做出正确诊断，于是进行了立体定向系列活检。标本的组织学检查显示为多形性胶质母细胞瘤（GBM），这是首例报告的位于获得性免疫缺陷综合征（AIDS）患者脑干的GBM病例。本文讨论了患者的管理以及立体定向系列活检的有效性。
