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伪装成脑结核瘤的囊性多形性胶质母细胞瘤。

Cystic glioblastoma multiforme masquerading as a cerebral tuberculoma.

作者信息

Hasan Mahboob, Siddiqui Bushra, Qadri Shagufta, Faridi Shahbaz

机构信息

Department of Pathology, Jawaharlal Nehru Medical College, Aligarh, Uttar Pradesh, India.

Department of Surgery, Jawaharlal Nehru Medical College, Aligarh, Uttar Pradesh, India.

出版信息

BMJ Case Rep. 2014 Oct 17;2014:bcr2014206832. doi: 10.1136/bcr-2014-206832.

Abstract

Glioblastoma multiforme (GBM) is by far the most common and most aggressive malignant neoplasm of the primary brain tumours. It arises from the astrocytes and classified as WHO grade 4 astrocytoma. Diagnosis of GBM is sometimes difficult as radiological picture sometimes mimic with cerebral tuberculoma. In both the cases contrast-enhanced CT may show similar finding of a mass lesion with a hypodense centre surrounded by a ring of enhancement and any cyst if present. In the present case, a 45-year-old male patient presented with seizures and headache, a provisional diagnosis of tuberculoma was made on the basis of clinical and CT findings. However, on grounds of suspicion the patient was operated and fluid from the cyst was sent peroperatively for cytopathological examination which suggested the diagnosis of cystic GBM. This helped the surgeon to do maximum debulking of the tumour. Diagnosis was further confirmed by histopathology.

摘要

多形性胶质母细胞瘤(GBM)是目前原发性脑肿瘤中最常见、最具侵袭性的恶性肿瘤。它起源于星形胶质细胞,被归类为世界卫生组织4级星形细胞瘤。GBM的诊断有时很困难,因为影像学表现有时会与脑结核瘤相似。在这两种情况下,增强CT可能显示出类似的表现,即有一个低密度中心被强化环包围的肿块病变,以及如有囊肿的话也会显示出相应情况。在本病例中,一名45岁男性患者出现癫痫发作和头痛,根据临床和CT检查结果初步诊断为结核瘤。然而,出于怀疑对患者进行了手术,并在术中将囊肿内的液体送去做细胞病理学检查,结果提示为囊性GBM。这有助于外科医生最大限度地切除肿瘤。组织病理学进一步证实了诊断。

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