Venkatesh Manchikanti, Suneetha Pentyala, Kumar Veldurti Ananta Kiran, Santhi Vissa, Moscote-Salazar Luis Rafael, Agrawal Amit
Department of Radiology, Narayana Medical College, Narayana Medical College Hospital, Nellore, Andhra Pradesh, India.
Department of Neurosurgery, Narayana Medical College Hospital, Nellore, Andhra Pradesh, India.
Asian J Neurosurg. 2018 Jul-Sep;13(3):928-930. doi: 10.4103/ajns.AJNS_116_18.
Extensive en plaque intradural extramedullary tuberculomas can occur as a paradoxical response to chemotherapy for intracranial tuberculomas. We report a case of 31-year-old male who presented with backache and progressive weakness and urgency of micturition. Magnetic resonance imaging dorsolumbar spine which showed an ill-defined T1 hypointense and T2 heterointense lesion noted posterior to the thoracic spinal cord, extending from C7 to D5 vertebral levels suggestive of en plaque meningioma. The patient underwent D1-D5 laminectomy, with subtotal debulking of the tumor. The histopathological examination of lesion was suggestive of granulomatous inflammation with multinucleated and Langhan type giant cells confirming the diagnosis of tuberculoma.
广泛的硬脊膜内髓外结核瘤可作为颅内结核瘤化疗的一种矛盾反应出现。我们报告一例31岁男性,表现为背痛、进行性肌无力和排尿急迫感。胸腰段脊柱磁共振成像显示胸段脊髓后方有一个边界不清的T1低信号和T2混杂信号病变,从C7延伸至D5椎体水平,提示为斑块状脑膜瘤。患者接受了D1-D5椎板切除术,肿瘤大部分切除。病变的组织病理学检查提示为肉芽肿性炎症,有多核和朗汉斯型巨细胞,确诊为结核瘤。