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[孤立性神经结节病的鉴别诊断]

[Differential diagnosis of solitary neurosarcoidosis].

作者信息

Schelhorn J, Smesny U, Fitzek C, Brodhun M, Witte O W, Terborg C

机构信息

Klinik für Neurologie, Friedrich-Schiller-Universität Jena.

出版信息

Nervenarzt. 2005 Aug;76(8):984-7. doi: 10.1007/s00115-004-1864-7.

Abstract

Sarcoidosis is an inflammatory multisystemic disease characterised by noncaseating epithelioid granulomas. The lung is affected in over 90% of patients. According to clinical criteria, the nervous system is involved in 5-9%. However, in autopsy series this number increases to 25%. Solitary involvement of the nervous system without signs of systemic disease is rare and diagnostically cryptic. Due to the wide variety of neurologic symptoms, definite diagnosis of sarcoidosis is possible only by histopathological proof of noncaseating epithelioid granulomas. We report a 51-year-old woman who presented with chronic basal meningitis and involvement of the peripheral and central nervous system due to solitary neurosarcoidosis. Diagnostic procedures and differential diagnosis are discussed.

摘要

结节病是一种以非干酪样上皮样肉芽肿为特征的炎症性多系统疾病。超过90%的患者肺部会受到影响。根据临床标准,神经系统受累的患者占5% - 9%。然而,在尸检系列中,这一数字增加到25%。神经系统单独受累而无全身疾病体征的情况罕见且诊断隐匿。由于神经症状多种多样,只有通过非干酪样上皮样肉芽肿的组织病理学证据才能明确诊断结节病。我们报告一名51岁女性,因孤立性神经结节病出现慢性基底脑膜炎以及外周和中枢神经系统受累。文中讨论了诊断程序和鉴别诊断。

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