Tamura Yukiko, Umeda Yoshitaka, Umeda Maiko, Oyake Mutsuo, Usuda Hiroyuki, Fujita Nobuya
Department of Neurology, Nagaoka Red Cross Hospital.
Department of Pathology, Nagaoka Red Cross Hospital.
Rinsho Shinkeigaku. 2020 Aug 7;60(8):565-568. doi: 10.5692/clinicalneurol.60.cn-001436. Epub 2020 Jul 7.
A 49-year-old woman was admitted to our hospital with suspected hypertensive encephalopathy. On the basis of MRI showing leptomeningeal enhancement and Class V cytology of the CSF, she was diagnosed as having leptomeningeal carcinomatosis. Although no primary site was detected, a few melanin granules were observed at the third CSF examination. The atypical cells in the CSF demonstrated immunoreactivity for HMB-45 and S-100, which are specific markers of malignant melanoma. There have been few reports of meningeal melanomatosis in Japan. This case illustrates that immunostaining is diagnostically useful in patients with leptomeningeal carcinomatosis from neoplasms with unknown primary sites.
一名49岁女性因疑似高血压脑病入住我院。基于磁共振成像（MRI）显示软脑膜强化及脑脊液（CSF）V级细胞学检查结果，她被诊断为软脑膜癌病。尽管未检测到原发部位，但在第三次脑脊液检查时观察到了一些黑色素颗粒。脑脊液中的非典型细胞对HMB - 45和S - 100呈免疫反应，这两种是恶性黑色素瘤的特异性标志物。在日本，关于脑膜黑色素瘤病的报道很少。该病例表明免疫染色对原发部位不明的肿瘤所致软脑膜癌病患者的诊断具有重要价值。
