中枢神经系统的白血病浸润
LEUKAEMIC INVOLVEMENT OF CENTRAL NERVOUS SYSTEM.
作者信息
Akhtar M, Narayanaswamy A S, Kumar Rajat, Dham S K, Bhardwaj J R
机构信息
Senior Adviser (Medicine), No. 7 Air Force Hospital, Kanpur 208 004.
Consultant (Medicine and Neurology), Army Hospital, Delhi Cantt 110 010.
出版信息
Med J Armed Forces India. 1995 Jul;51(3):161-164. doi: 10.1016/S0377-1237(17)30957-7. Epub 2017 Jun 26.
Eighty two patients of leukaemia consisting of 25 cases of acute lymphocytic leukaemia, 38 cases of acute myeloid leukaemia, 14 cases of chronic myeloid leukaemia and 5 cases of chronic lymphocytic leukaemia were evaluated for central nervous system (CNS) involvement. Speech disorders, cranial nerve palsies, encephalopathy, ataxia, intracranial haemorrhage, peripheral neuropathy and spinal cord involvement were the main neurological findings detected in 23 (28.1%) cases. All except one were subjected to autopsy after death. Leukaemic infiltrations (36.6%) and intracranial haemorrhage (26.8%) were the prominent CNS autopsy findings. In addition, demyelination with astrocytosis (9.7%) and gliosis (2.4%) were seen. In all, 45 (54.9%) of the patients showed CNS involvement at autopsy. Thus a large number of CNS lesions were missed clinically and detected only on autopsy.
对82例白血病患者进行了中枢神经系统（CNS）受累情况评估，其中包括25例急性淋巴细胞白血病、38例急性髓细胞白血病、14例慢性髓细胞白血病和5例慢性淋巴细胞白血病。言语障碍、颅神经麻痹、脑病、共济失调、颅内出血、周围神经病变和脊髓受累是在23例（28.1%）患者中检测到的主要神经学表现。除1例患者外，其余患者均在死后进行了尸检。白血病浸润（36.6%）和颅内出血（26.8%）是主要的中枢神经系统尸检发现。此外，还可见脱髓鞘伴星形细胞增生（9.7%）和胶质增生（2.4%）。总体而言，45例（54.9%）患者在尸检时显示中枢神经系统受累。因此，大量中枢神经系统病变在临床上被漏诊，仅在尸检时才被发现。
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