Lin Yi-Heng, Chang Yen-Wen, Yang Shih-Hung, Chang Hsiu-Hao, Lu Meng-Yao, Fan Pi-Chuan
Department of Pediatrics, National Taiwan University Hospital and National Taiwan University, College of Medicine, Taipei, Taiwan.
Department of Surgery, National Taiwan University Hospital and National Taiwan University, College of Medicine, Taipei, Taiwan.
J Formos Med Assoc. 2015 Sep;114(9):886-90. doi: 10.1016/j.jfma.2012.10.024. Epub 2013 Jan 3.
Spinal cord involvement in gliomatosis cerebri (GC) is uncommon. We report two patients with GC, who initially presented with chronic meningitis and were treated with antituberculous drugs. Although tumor meningitis was suspected, due to the intractable clinical course, a correct diagnosis was established after performing a biopsy examination of the metastatic spinal lesion which was detected by magnetic resonance imaging (MRI). Cerebrospinal fluid examination, including cytology, should be performed repetitively for patients with chronic meningitis refractory to antibiotic treatment. Spinal MRI is necessary for the complete neurological workup, even when the patients do not show spinal symptoms.
脊髓受累于大脑胶质瘤病(GC)并不常见。我们报告了两名GC患者,他们最初表现为慢性脑膜炎并接受了抗结核药物治疗。尽管怀疑是肿瘤性脑膜炎,但由于临床病程棘手,在对磁共振成像(MRI)检测到的转移性脊柱病变进行活检检查后才确立了正确诊断。对于对抗生素治疗无效的慢性脑膜炎患者,应反复进行包括细胞学检查在内的脑脊液检查。即使患者没有脊柱症状,脊柱MRI对于全面的神经系统检查也是必要的。