Nakanishi Etsuro, Sawamura Masanori, Maruhama Shinichiro, Yamada Hiroshi, Kim Gan, Harada Kiyoshi
Department of Neurology, Shizuoka General Hospital.
Rinsho Shinkeigaku. 2015;55(1):13-7. doi: 10.5692/clinicalneurol.55.13.
In a 72-year-old female, subacute right hemiplegia and aphasia appeared in late May 2011. The results of hematology, a cerebrospinal fluid test, (13)F-FDG-PET, and cephalic MRI suggested intravascular/malignant lymphoma. Brain biopsy was performed. Pathological findings did not suggest a malignant tumor. In the perivascular space, the infiltration of neutrophils or histiocytes was observed. The patient was referred to the Department of Neurology. Based on the results of various examinations, infection was ruled out, and steroid therapy was conducted. Marked improvement was achieved. Subsequently, the results of human leukocyte antigen (HLA) typing showed B54/Cw1. As dermal findings were absent, it was impossible to make a definitive diagnosis of neuro-Sweet disease, but the disorder was regarded as a neuro-neutrophilic disease, which is a more comprehensive entity. Few studies have reported brain tissue findings of active neuro-neutrophilic disease. We report the present case, which will contribute to future research.
2011年5月末,一名72岁女性出现亚急性右半身偏瘫和失语。血液学检查、脑脊液检查、(13)F-FDG-PET检查及头部MRI检查结果提示血管内/恶性淋巴瘤。遂进行脑活检。病理检查结果未提示恶性肿瘤。在血管周围间隙观察到中性粒细胞或组织细胞浸润。该患者被转诊至神经内科。基于各项检查结果,排除感染因素后进行了类固醇治疗,患者病情明显改善。随后,人类白细胞抗原(HLA)分型结果显示为B54/Cw1。由于未出现皮肤表现,无法确诊为神经Sweet病,但该疾病被视为一种神经嗜中性疾病,这是一个更具综合性的概念。鲜有研究报道活动性神经嗜中性疾病的脑组织检查结果。我们报告本病例,希望能为未来的研究提供帮助。