胶质母细胞瘤伪装成自身免疫性边缘叶脑炎：1例病例及文献综述
Glioblastoma as an autoimmune limbic encephalitis mimic: A case and review of the literature.
作者信息
Macchi Zachary A, Kleinschmidt-DeMasters B K, Orjuela Karen D, Pastula Daniel M, Piquet Amanda L, Baca Christine B
机构信息
Department of Neurology, University of Colorado School of Medicine, Aurora, CO, United States of America.
Department of Neurology, University of Colorado School of Medicine, Aurora, CO, United States of America; Department of Pathology, University of Colorado School of Medicine, Aurora, CO, United States of America.
出版信息
J Neuroimmunol. 2020 Mar 7;342:577214. doi: 10.1016/j.jneuroim.2020.577214.
A 43-year-old woman presented with cognitive decline, focal seizures, brain MRI showing non-enhancing, bilateral hippocampal lesions, but normal cerebrospinal fluid findings, which fulfilled the Graus et al., 2016 criteria for autoimmune limbic encephalitis (ALE). Subjective improvements were observed after immunotherapy. A repeat brain MRI showed new contrast enhancement and positron emission tomography revealed left hippocampal uptake. Biopsy of the right parahippocampus yielded high-grade glioma. Five similar cases, among the 14 with unilateral hippocampal lesions on MRI, were identified in the literature whereby suspected ALE preceded the high-grade glioma diagnosis. Gliomas confined to hippocampi can have clinical features overlapping with ALE.
一名43岁女性出现认知功能减退、局灶性癫痫发作，脑部磁共振成像（MRI）显示双侧海马区有非强化性病变，但脑脊液检查结果正常，符合2016年格劳斯等人提出的自身免疫性边缘叶脑炎（ALE）标准。免疫治疗后观察到主观症状有所改善。再次脑部MRI显示有新的对比增强，正电子发射断层扫描显示左侧海马区有摄取。右侧海马旁回活检显示为高级别胶质瘤。在文献中，在14例MRI显示单侧海马区病变的病例中，发现了5例类似病例，即疑似ALE先于高级别胶质瘤的诊断。局限于海马区的胶质瘤可具有与ALE重叠的临床特征。
Zotero 插件