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小脑皮质发育异常性颗粒分子层肥大(L'hermitte-Duclos病):三例报告

Dysplastic granulo-molecular hypertrophy of the cerebellar cortex (L'hermitte-Duclos disease): report of three cases.

作者信息

Poljaković Z, Jadro-Santel D, Besenski N, Popović M, Pazanin L, Negovetić L

机构信息

Department of Neuropathology, Clinical Medical Center, Zagreb.

出版信息

Neurologija. 1990;39(4):259-71.

PMID:2290472
Abstract

In this paper three cases with peculiar disease of the cerebellar cortex are presented. The disease is well known as L'hermitte-Duclos disease (LDD), but nowadays it is also called "dysplastic granulo-molecular hypertrophy of the cerebellar cortex" according to the modern theories of its etiology. Curious changes of the cerebellum in LDD are probably the result of a combination of delayed migration of Purkinje cells which occurs during the intrauterine period of cerebellar development, and of reactive hypertrophy of granular cells. Presented cases of L'hermitte-Duclos disease are, according to the literature, more or less typical by their clinical appearance and by their histological findings. Our electromicroscopical data support the findings of those authors who found only axodendritic sinapses on the hypertrophied ganglion cells, according to the idea that those cells are originally granular cells of the cerebellar cortex. CT scan of all our patients revealed parallel, worm-like, hyperdense formations in a hypodense process of the cerebellum. The same picture existed in some other described patients, but attention was paid to it. We consider this picture on the computed tomography to be characteristic, if not even patognomonic for the L'hermitte-Duclos disease, which gives us an entirely new scientific contribution in the process of the diagnosis of this peculiar disease.

摘要

本文介绍了三例患有小脑皮质特殊疾病的病例。该疾病被熟知为L'hermitte-Duclos病(LDD),但如今根据其病因的现代理论,它也被称为“小脑皮质发育异常性颗粒-分子层肥大”。LDD中小脑的奇特变化可能是由于在小脑发育的宫内期发生的浦肯野细胞迁移延迟与颗粒细胞反应性肥大共同作用的结果。根据文献,所呈现的L'hermitte-Duclos病病例在临床表现和组织学发现方面或多或少具有典型性。我们的电镜数据支持了那些作者的发现,即根据那些细胞原本是小脑皮质颗粒细胞的观点,在肥大的神经节细胞上仅发现轴突树突突触。我们所有患者的CT扫描显示在小脑的低密度区域内有平行的、蠕虫状的高密度结构。在其他一些已描述的患者中也存在同样的图像,但当时对此有所关注。我们认为这种CT图像即使不是L'hermitte-Duclos病的特征性表现,至少也是其标志性表现,这在这种特殊疾病的诊断过程中为我们提供了全新的科学贡献。

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