脑脊液中的胆囊癌细胞作为肿瘤的首发表现。一例病例报告。
Gallbladder carcinoma cells in cerebrospinal fluid as the first manifestation of a tumor. A case report.
作者信息
Glosová Libuse, Dundr Pavel, Effler Josef, Růzicková Marie
机构信息
Department of Neurology, Second Medical Faculty, Charles University, Motol Hospital, V Uvalu 84, 150 18 Prague 5, Czech Republic.
出版信息
Acta Cytol. 2003 Nov-Dec;47(6):1087-90. doi: 10.1159/000326653.
BACKGROUND
Meningeal carcinomatosis (MC) rarely occurs as the first evidence of a tumor. In such cases cytology of the cerebrospinal fluid is crucial to the diagnosis. The most frequent primary MCs are lung and breast cancers. MC from a gallbladder carcinoma is uncommon.
CASE
A 58-year-old woman presented with paroxysmal headaches, seizures and coma. Analysis of the cerebrospinal fluid revealed carcinoma cells and a low protein concentration. Only postmortem examination discovered gallbladder adenocarcinoma to be the source of the tumor cells.
CONCLUSION
A case with the onset of MC secondary to rare mucinous adenocarcinoma of the gallbladder is presented. Cytology of the cerebrospinal fluid was the only examination that uncovered malignancy. Nine similar cases were found in the literature. Low cerebrospinal fluid protein seems to be of diagnostic value.
背景
脑膜癌病（MC）很少作为肿瘤的首发证据出现。在这种情况下，脑脊液细胞学检查对诊断至关重要。最常见的原发性脑膜癌病源于肺癌和乳腺癌。源于胆囊癌的脑膜癌病并不常见。
病例
一名58岁女性出现阵发性头痛、癫痫发作和昏迷。脑脊液分析发现癌细胞且蛋白浓度较低。仅尸检发现胆囊腺癌是肿瘤细胞的来源。
结论
本文报道了一例继发于罕见的胆囊黏液腺癌的脑膜癌病病例。脑脊液细胞学检查是唯一发现恶性肿瘤的检查。文献中发现了9例类似病例。脑脊液蛋白水平低似乎具有诊断价值。
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