以视乳头水肿及假瘤综合征为表现的原发性柔脑膜淋巴瘤病例
Case of Primary Leptomeningeal Lymphoma Presenting with Papilloedema and Characteristics of Pseudotumor Syndrome.
作者信息
Takagi Mai, Oku Hidehiro, Kida Teruyo, Akioka Toshikazu, Ikeda Tsunehiko
机构信息
Department of Ophthalmology, Osaka Medical College, Osaka, Japan.
Department of Internal Medicine, Osaka Medical College, Osaka, Japan.
出版信息
Neuroophthalmology. 2017 Mar 23;41(3):149-153. doi: 10.1080/01658107.2017.1292533. eCollection 2017 Jun.
The authors describe an immunocompetent, 50-year-old man who complained of a daily transient blurring of his vision with bilateral papilloedema. His visual acuity was 20/20 OU, and the blind spot was enlarged bilaterally. There was intracranial hypertension, but imaging for systemic and brain tumours were negative. These findings suggested a diagnosis of the pseudotumor syndrome. However, MRI showed leptomeningeal enhancement, and acetazolamide successfully resolved his visual symptoms and papilloedema. Cytology and flow cytometry of the CSF led to the final diagnosis of primary leptomeningeal lymphoma (PLML). Clinicians need to be aware that a case of PLML may be misdiagnosed as peudotumor cerebri.
作者描述了一名50岁免疫功能正常的男性，他主诉每天出现短暂视力模糊并伴有双侧视乳头水肿。其双眼视力均为20/20，双侧盲点扩大。存在颅内高压，但全身和脑部肿瘤的影像学检查均为阴性。这些发现提示为假瘤综合征的诊断。然而，磁共振成像（MRI）显示软脑膜强化，乙酰唑胺成功缓解了他的视觉症状和视乳头水肿。脑脊液的细胞学和流式细胞术检查最终确诊为原发性软脑膜淋巴瘤（PLML）。临床医生需要意识到，PLML病例可能会被误诊为假性脑瘤。
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