Kocovski Linda, Parasu Naveen, Provias John P, Popovic Snezana
Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada.
Department of Radiology, McMaster University, Hamilton, Ontario, Canada.
Can Assoc Radiol J. 2015 May;66(2):108-14. doi: 10.1016/j.carj.2014.07.004. Epub 2015 Jan 8.
To describe the radiologic and corresponding histopathologic features of calcifying pseudoneoplasms of the neural axis.
Two cases of calcifying pseudoneoplasm of the neural axis were retrospectively reviewed. The first case was documented in a 64-year-old woman, who presented with lower back pain with radiation to her left leg. The second case was documented in a 70-year-old man, who presented with headaches. Medical records, radiologic and histologic findings, and related literature were reviewed.
In the first case, imaging of the lumbar spine revealed a 3.8 × 2.2-cm calcified lesion at the level of vertebrae L5 and S1. A subsequent excision exposed an extradural lesion at L5. Histopathologic examination showed amorphous and granular calcifying material with occasional fibrohistiocytic and giant cell reaction, consistent with calcifying pseudoneoplasm of the neural axis. In the second case, imaging of the head revealed a 2.4 × 2.6-cm well-circumscribed, lobulated, calcified lesion within the basal frontal lobe. Subsequent resection exposed an intradural mass with a nodular arrangement of amorphous and granular calcifying material associated with fibrohistiocytic and giant cell reaction. Both patients had a favorable postoperative course and failed to show any clinical or radiologic sign of recurrence.
Calcifying pseudoneoplasm of the neural axis is an uncommon condition with an excellent prognosis but is often misdiagnosed due to its nonspecific clinical presentation and varied findings on radiology.
描述神经轴钙化性假瘤的放射学及相应组织病理学特征。
回顾性分析2例神经轴钙化性假瘤病例。第一例为一名64岁女性，表现为下背部疼痛并向左腿放射。第二例为一名70岁男性，表现为头痛。对病历、放射学和组织学检查结果以及相关文献进行了回顾。
第一例中，腰椎影像学检查显示L5和S1椎体水平有一个3.8×2.2 cm的钙化病变。随后的切除显示L5水平有一个硬膜外病变。组织病理学检查显示有无定形和颗粒状钙化物质，偶见纤维组织细胞和巨细胞反应，符合神经轴钙化性假瘤。第二例中，头部影像学检查显示额叶底部有一个2.4×2.6 cm边界清楚、分叶状的钙化病变。随后的切除显示一个硬膜内肿块，有无定形和颗粒状钙化物质呈结节状排列，并伴有纤维组织细胞和巨细胞反应。两名患者术后病程良好，未出现任何临床或放射学复发迹象。
神经轴钙化性假瘤是一种罕见疾病，预后良好，但由于其非特异性临床表现和放射学表现多样，常被误诊。
