Kuwahara Hiroomi, Yamada Tadaaki, Yuba Tatsuya, Kono Kenji, Hosogi Shigekuni, Osugi Shuji, Nagata Kazuhiro, Yokomura Ichiro, Iwasaki Yoshinobu
Division of Pulmonary Medicine, Kyoto Prefectural University of Medicine.
Nihon Kokyuki Gakkai Zasshi. 2005 May;43(5):296-301.
We report 4 cases of spinal cord metastases of lung cancer detected by MRI. Histologically, 3 of the 4 cases were small cell carcinoma and the other was adenocarcinoma. All 3 cases of small cell carcinoma had neoplastic meningitis. MRI taken in these cases showed the multiple nodules in the cauda equina, which were seeded from brain metastases. One of them had intramedullary spinal cord metastases, which appeared as enlargement of the spinal cord or nodules in the spinal cord on MRI. Leg paralysis and incontinence progressed in all cases. The other case of adenocarcinoma had epidural spinal cord compression due to spinal metastasis. In this case irradiation and corticosteroids relieved her leg and back pain. Spinal cord metastases should be considered as a differential diagnosis in patients with numbness, pain or weakness in the extremities.
我们报告4例经磁共振成像（MRI）检测出的肺癌脊髓转移病例。组织学检查显示，4例中有3例为小细胞癌，另1例为腺癌。3例小细胞癌均伴有肿瘤性脑膜炎。这些病例的MRI显示马尾有多个结节，是由脑转移播散而来。其中1例有脊髓内转移，MRI表现为脊髓增粗或脊髓内结节。所有病例均出现腿部瘫痪和尿失禁进展。另1例腺癌病例因脊柱转移导致硬膜外脊髓压迫。在此病例中，放疗和皮质类固醇缓解了她的腿部和背部疼痛。对于有肢体麻木、疼痛或无力的患者，应考虑脊髓转移作为鉴别诊断。
