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[多形性胶质母细胞瘤中的中枢神经系统曲霉菌病]

[Aspergillosis of the central nervous system in glioblastoma multiforme].

作者信息

Noä G, Wowra B, Blimke B, Gademann G, Schmitt H P

机构信息

Institut für Neuropathologie, Universität Heidelberg.

出版信息

Neurochirurgia (Stuttg). 1991 Jul;34(4):119-24. doi: 10.1055/s-2008-1052069.

Abstract

A 45 year-old male with a butterfly glioma received stereotactic biopsy for histologic confirmation of the clinical diagnosis. Microscopically, the results were controversial since some biopsy specimens showed distinct inflammatory changes, while others displayed typical features of a malignant glioma. The patient died four days after the stereotactic approach due to therapy-resistant intracranial pressure rise. In addition to a large butterfly glioblastoma originating from the frontal part of the corpus callosum, neuropathologic examination revealed a mycotic encephalitis with formation of numerous fungi-containing inflammatory foci in all parts of the brain and in the glioma. General autopsy disclosed pulmonary aspergillosis as the source of the inflammatory spread. A previous steroid medication over several weeks for treatment of increased intracranial pressure may be considered as an important factor in the origin of the pulmonary aspergillosis complicating the butterfly glioma.

摘要

一名患有蝶形胶质瘤的45岁男性接受了立体定向活检,以对临床诊断进行组织学确认。显微镜检查结果存在争议,因为一些活检标本显示出明显的炎症变化,而另一些则表现出恶性胶质瘤的典型特征。该患者在立体定向手术后四天因治疗抵抗性颅内压升高死亡。除了起源于胼胝体前部的巨大蝶形胶质母细胞瘤外,神经病理学检查还发现了霉菌性脑炎,在大脑各部位和胶质瘤中均形成了大量含真菌的炎症病灶。全身尸检显示肺曲霉菌病是炎症扩散的源头。此前数周用于治疗颅内压升高的类固醇药物治疗可能被视为并发蝶形胶质瘤的肺曲霉菌病发病的一个重要因素。

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