Arai Masayuki, Kashihara Kengo, Kaizaki Yasuharu, Taguchi Motohiro, Kitamura Yoshihisa
Department of Neurosurgery, Fukui Prefectural Hospital, Yotsui 2-8-1, Fukui City 910-8526, Japan.
No To Shinkei. 2003 Oct;55(10):890-7.
Gliomatosis cerebri is a rare tumor of the central nervous system characterized by widespread diffuse infiltration of the brain and spinal cord by neoplastic glial cells. The diagnosis of gliomatosis cerebri with MR imaging remains difficult. We presented three interesting cases of gliomatosis cerebri. Case 1 showed transformation from type 1 gliomatosis cerebri to type 2. Case 2 showed that the initial thalamic lesion extended into brain stem, cerebellar hemisphere and right cerebral hemisphere. After radiation therapy, the right cerebral cortex demonstrated hyperintensity on T1- and hypointensity on T2-weighted image. These two cases did not demonstrate diffuse brain swelling or indistinctness of gray/white matter border on the first MR imaging. Case 3 showed two histological components of oligodendroglioma in the corpus callosum and astrocytoma in the cingulate gyrus. Case 3 improved in response to radiotherapy and chemotherapy using procarbazine/MCNU/vincristine (MVP). We also reviewed recent literatures.
大脑胶质瘤病是一种罕见的中枢神经系统肿瘤,其特征是肿瘤性胶质细胞广泛弥漫浸润脑和脊髓。采用磁共振成像(MR)对大脑胶质瘤病进行诊断仍然具有挑战性。我们展示了3例有趣的大脑胶质瘤病病例。病例1显示了从1型大脑胶质瘤病向2型的转变。病例2显示最初的丘脑病变扩展至脑干、小脑半球和右侧大脑半球。放射治疗后,右侧大脑皮质在T1加权像上呈高信号,在T2加权像上呈低信号。这2例在首次MR成像时均未显示弥漫性脑肿胀或灰白质边界不清。病例3显示胼胝体有少突胶质细胞瘤和扣带回有星形细胞瘤这两种组织学成分。病例3对使用丙卡巴肼/甲基环己亚硝脲/长春新碱(MVP)的放化疗有反应。我们还回顾了近期的文献。