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以颅内高压为表现的肿瘤性脑膜炎的诊断挑战。

Diagnostic challenges in neoplastic meningitis presenting as intracranial hypertension.

作者信息

Andugulapati Santosh Sriram, Chheda Akash, Desai Karan, Ravat Sangeeta Hasmukh

机构信息

Department of Neurology, Seth GS Medical College and KEM Hospital, Mumbai, Maharastra, India.

Department of Neurology, Seth GS Medical College and KEM Hospital, Mumbai, Maharastra, India

出版信息

BMJ Case Rep. 2021 Mar 10;14(3):e238808. doi: 10.1136/bcr-2020-238808.

DOI:10.1136/bcr-2020-238808
PMID:33692049
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7949390/
Abstract

A diagnosis of idiopathic intracranial hypertension should be considered only after careful exclusion of all possible aetiologies. We report a case of neoplastic meningitis presenting as intracranial hypertension with inconclusive repeated cerebrospinal fluid (CSF) cytology and MRI of brain, emphasising the importance of meticulous CSF analysis and role of early whole-body PET-CT scan for diagnosis of systemic malignancy.

摘要

仅在仔细排除所有可能病因后，才应考虑特发性颅内高压的诊断。我们报告一例以颅内高压为表现的肿瘤性脑膜炎病例，其脑脊液（CSF）细胞学检查和脑部MRI多次结果不明确，强调了细致的脑脊液分析的重要性以及早期全身PET-CT扫描在诊断系统性恶性肿瘤中的作用。

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本文引用的文献

1
Intracranial Leptomeningeal Carcinomatosis: A Diagnostic Study with F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography.颅内柔脑膜癌病：一项¹⁸F-氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描的诊断研究
Case Rep Neurol. 2018 Feb 9;10(1):45-53. doi: 10.1159/000486710. eCollection 2018 Jan-Apr.
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Clinical Presentation, Diagnosis, and Radiological Findings of Neoplastic Meningitis.肿瘤性脑膜炎的临床表现、诊断及影像学表现
Cancer Control. 2017 Jan;24(1):9-21. doi: 10.1177/107327481702400103.
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PET/MRI imaging unmasks leptomeningeal carcinomatosis in unexplained diplopia.PET/MRI成像揭示了不明原因复视中的柔脑膜癌病。
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5
Intracranial Leptomeningeal Carcinomatosis from Breast Cancer Detected on 18F-FDG PET.18F-FDG PET检测出的乳腺癌颅内柔脑膜癌转移
J Nucl Med Technol. 2015 Sep;43(3):227-8. doi: 10.2967/jnmt.114.148791. Epub 2015 Feb 5.
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Potential of F-18 PET/CT in the Detection of Leptomeningeal Metastasis.F-18正电子发射断层显像/计算机断层扫描（PET/CT）在检测软脑膜转移中的应用潜力
Neuroradiol J. 2014 Dec;27(6):685-9. doi: 10.15274/NRJ-2014-10098. Epub 2014 Dec 1.
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Idiopathic intracranial hypertension in men.男性特发性颅内高压
Neurology. 2009 Jan 27;72(4):304-9. doi: 10.1212/01.wnl.0000333254.84120.f5. Epub 2008 Oct 15.
8
Brain abnormalities detected on whole-body 18F-FDG PET in cancer patients: spectrum of findings.癌症患者全身18F-FDG PET检查中发现的脑部异常：表现谱
AJR Am J Roentgenol. 2007 Mar;188(3):866-73. doi: 10.2214/AJR.06.0109.
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Neoplastic meningitis.肿瘤性脑膜炎
Neurologist. 2006 Jul;12(4):179-87. doi: 10.1097/01.nrl.0000219732.33321.cc.
10
Neoplastic meningitis from systemic malignancies: diagnosis, prognosis and treatment.系统性恶性肿瘤所致的肿瘤性脑膜炎：诊断、预后及治疗
Semin Oncol. 2006 Jun;33(3):312-23. doi: 10.1053/j.seminoncol.2006.04.016.