Department of Neurosurgery, University of Rome Sapienza, Rome, Italy.
World J Surg Oncol. 2010 Jan 15;8:3. doi: 10.1186/1477-7819-8-3.
There are several non-neoplastic lesions which mimick intramedullary spinal cord neoplasm in their radiographic and clinical presentation. These can be classified as either infectious (TB, fungal, bacterial, parasytic, syphilis, CMV, HSV) and non-infectious (sarcoid, MS, myelitis, ADEM, SLE) inflammatory lesions, idiopathic necrotizing myelopathy, unusual vascular lesions and radiation myelopathy. Although biopsy may be indicated in many cases, an erroneous diagnosis of intramedullary neoplasm can often be eliminated pre-operatively.
the authors report a very rare case of intramedullary non-specific inflammatory lesion of unknown origin, without signs of infection or demyelinization, in a woman who showed no other evidence of systemic disease.
Intramedullary lesions that mimick a tumor can be various and difficult to interpret. Preoperative MRI does not allow a certain diagnosis because these lesions have a very similar signal intensity pattern. Specific tests for infective pathologies are useful for diagnosis, but histological examination is essential for establishing a certain diagnosis. In our case the final histological examination and the specific tests that we performed have not cleared our doubts regarding the nature of the lesion that remains controversial.
有几种非肿瘤性病变在影像学和临床表现上类似于脊髓内肿瘤。这些病变可分为感染性（结核、真菌、细菌、寄生虫、梅毒、巨细胞病毒、单纯疱疹病毒）和非感染性（结节病、多发性硬化、脊髓炎、急性播散性脑脊髓炎、系统性红斑狼疮）炎症性病变、特发性坏死性脊髓病、不常见的血管病变和放射性脊髓病。虽然在许多情况下可能需要进行活检，但术前常可排除脊髓内肿瘤的错误诊断。
作者报告了一例非常罕见的女性脊髓内非特异性炎症性病变，无感染或脱髓鞘迹象，也无其他系统性疾病的证据。
类似于肿瘤的脊髓内病变可能多种多样，难以解释。术前 MRI 检查不能做出明确诊断，因为这些病变的信号强度模式非常相似。针对感染性病变的特定检查有助于诊断，但组织学检查对于明确诊断至关重要。在我们的病例中，最终的组织学检查和我们进行的特定检查并没有消除我们对病变性质的疑虑，该病变仍存在争议。
