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多形性胶质母细胞瘤伪装为肿块样脱髓鞘病变:尸检中得到的教训。

Glioblastoma multiforme masquerading as a tumefactive demyelinating lesion: Lessons learned at autopsy.

机构信息

Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Department of Neurology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

出版信息

Neurol India. 2016 Jul-Aug;64(4):737-41. doi: 10.4103/0028-3886.185351.

Abstract

Tumefactive demyelinating (TD) lesions are extremely challenging lesions to diagnose during their histopathological examination and are often misdiagnosed as tumors. On the contrary, a glioblastoma multiforme is rarely misdiagnosed as a TD unless the two coexist. We present a case of a 60-year old man who was diagnosed as having tumefactive demyelination on a stereotactic biopsy. At autopsy, however, the lesion revealed a grade IV glioblastoma. The myelin loss along the periphery of the lesion was erroneously interpreted as TD during the histopathological examination. We have described the imaging, the biopsy, and the autopsy findings of this instructive case. It is pertinent to recognize its histology to prevent a misdiagnosis.

摘要

肿块样脱髓鞘病变(TD)在组织病理学检查中极具诊断挑战性,且常被误诊为肿瘤。相反,胶质母细胞瘤很少被误诊为 TD,除非两者同时存在。我们报告了一例 60 岁男性患者,在立体定向活检中被诊断为肿块样脱髓鞘病变。然而,尸检显示病变为 4 级胶质母细胞瘤。在组织病理学检查中,病变周边的髓鞘丢失被错误地解释为 TD。我们描述了这个有启发性的病例的影像学、活检和尸检结果。认识到其组织病理学特征对于防止误诊至关重要。

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