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组织细胞增生症样脑肿瘤:2 例罕见病例报告。

Histiocytic Disorder Mimicking a Brain Tumor: A Report of 2 Rare Cases.

机构信息

Department of Pathology, Emory University, Atlanta, GA, USA.

Department of Pathology and Translational Pathobiology, Louisiana State University Health-Shreveport, Shreveport, LA, USA.

出版信息

Am J Case Rep. 2022 Aug 16;23:e935885. doi: 10.12659/AJCR.935885.

Abstract

BACKGROUND Histiocytic disorders, a group of disorders with heterogeneous pathogenesis, morphology, and clinical presentation, include Rosai-Dorfman disease, Langerhans cell histiocytosis, and Erdheim-Chester disease. They can mimic primary or metastatic tumors, both clinically and radiologically, when involving the brain. Therefore, it is crucial to present and discuss cases of histiocytic disorder involving the central nervous system (CNS) to provide new information on disease presentation and diagnosis more. In this paper, we present 2 cases of histiocytic lesions involving the brain and mimicking primary brain tumors. CASE REPORT Case 1: A 65-year-old man presented with increasing memory loss, confusion, and depression. CT scans showed an isolated 2.9×2.0×0.6 cm intracranial hypothalamic lesion. Case 2: A 61-year-old woman presented with dizziness and confusion for 3 weeks and headaches for 1 day. MRI showed a single 5.0×4.0×3.3 cm extra-axial, dural-based, avidly enhancing, well-defined lesion along the left parietal convexity causing mass effect upon the underlying brain parenchyma, left atrial effacement, and minimal vasogenic edema. CONCLUSIONS Histiocytic disorders are relatively rare in the CNS compared with other locations and mimic more common entities in the brain, such as glioma or metastatic tumors. Despite its rarity, one should remain aware of the condition and consider it in the differential diagnosis. This article provides a brief review and adds pivotal data to the literature.

摘要

背景

组织细胞增多症是一组具有异质性发病机制、形态和临床表现的疾病,包括 Rosai-Dorfman 病、朗格汉斯细胞组织细胞增生症和 Erdheim-Chester 病。当涉及大脑时,它们在临床上和影像学上可以模拟原发性或转移性肿瘤。因此,呈现和讨论涉及中枢神经系统(CNS)的组织细胞增多症病例对于提供更多关于疾病表现和诊断的新信息至关重要。在本文中,我们呈现了 2 例涉及大脑并模拟原发性脑肿瘤的组织细胞病变病例。

病例报告

病例 1:一名 65 岁男性,表现为记忆力减退、意识混乱和抑郁加重。CT 扫描显示孤立性 2.9×2.0×0.6cm 颅内下丘脑病变。

病例 2:一名 61 岁女性,因头晕和意识混乱 3 周,头痛 1 天就诊。MRI 显示单一 5.0×4.0×3.3cm 颅外、硬膜内、明显强化、边界清楚的病变,沿左顶叶凸面延伸,对下方脑实质产生占位效应,左心房闭塞,轻度血管源性水肿。

结论

与其他部位相比,组织细胞增多症在 CNS 中相对少见,并且在大脑中模拟更常见的实体,如神经胶质瘤或转移性肿瘤。尽管罕见,但应注意到这种情况,并在鉴别诊断中考虑到它。本文提供了一个简要的回顾,并为文献增添了关键数据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1309/9393051/a9c9fd05a434/amjcaserep-23-e935885-g001.jpg

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