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[颅内多发病变:62例临床病理研究]

[Multiple intracranial lesions: a clinicalpathologic study of 62 cases].

作者信息

Zhang Xiao-juan, Piao Yue-shan, Chen Li, Tang Guo-cai, Wei Li-feng, Yang Hong, Lu De-hong

机构信息

Department of Pathology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China.

出版信息

Zhonghua Bing Li Xue Za Zhi. 2011 Sep;40(9):599-603.

PMID:22177243
Abstract

OBJECTIVE

To study the clinicalpathologic features of intracranial multiple lesions.

METHODS

The clinical, radiologic and pathologic features of intracranial multiple lesions in 62 cases during the period from 2005 to 2009 in Xuanwu Hospital were retrospectively reviewed.

RESULTS

There were 32 males and 30 females in 62 cases. The mean age of seize onset and duration of disease were 37.4-year-old and 11.6 months, respectively. The lesions could affect cerebral hemisphere, basal ganglia, brain stem, cerebellum and other parts, most lesions were located above the tentorium. Pathological diagnosis as follows: 13 patients with glioma; metastatic tumors in 13 cases; 12 cases of central nervous system infection; immune-mediated inflammatory demyelinating disease in 8 cases; 5 cases of primary lymphoma of central nervous system; primary angiitis of the central nervous system 3 cases; mitochondrial encephalopathy 2 cases; vein thrombosis in 2 cases; Rosai-Dorfman disease in 2 cases; 2 case of radiation encephalopathy. Among them, mitochondrial encephalopathy and vein thrombosis lesions located in the cortex; metastatic tumor and blood-borne infection mainly involving junction of grey and white matter; glioma, radiation encephalopathy and demyelinating disease include white matter lesions; vascular inflammation showed cortical and subcortical white matter lesions.

CONCLUSIONS

A variety of tumor and non-neoplastic diseases can be expressed in intracranial multiple lesions, which gliomas, metastatic tumor and central nervous system infections are more common. In order to improve the diagnosis of intracranial multiple lesions, active work in the brian biopsy, study the clinical, imaging and pathological findings must be closely.

摘要

目的

研究颅内多发病变的临床病理特征。

方法

回顾性分析2005年至2009年期间在宣武医院就诊的62例颅内多发病变患者的临床、影像学及病理特征。

结果

62例患者中男性32例,女性30例。癫痫发作的平均年龄和病程分别为37.4岁和11.6个月。病变可累及大脑半球、基底节、脑干、小脑等部位,多数病变位于幕上。病理诊断如下:胶质瘤13例;转移瘤13例;中枢神经系统感染12例;免疫介导性炎性脱髓鞘疾病8例;中枢神经系统原发性淋巴瘤5例;中枢神经系统原发性血管炎3例;线粒体脑病2例;静脉窦血栓形成2例;Rosai-Dorfman病2例;放射性脑病2例。其中,线粒体脑病和静脉窦血栓形成病变位于皮质;转移瘤和血行感染主要累及灰白质交界区;胶质瘤、放射性脑病和脱髓鞘疾病以白质病变为主;血管炎性病变表现为皮质及皮质下白质病变。

结论

多种肿瘤及非肿瘤性疾病均可表现为颅内多发病变,其中胶质瘤、转移瘤及中枢神经系统感染较为常见。为提高颅内多发病变的诊断水平,应积极开展脑活检工作,密切研究临床、影像学及病理表现。

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