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儿童鞍区和鞍上病变的鉴别诊断:幼年黄色肉芽肿病例报告及文献复习。

Juvenile xanthogranuloma as a differential diagnosis for sellar and suprasellar lesions in child: Case report and review of literature.

机构信息

Department of Medicine, Federal University of Sergipe, Campus Professor Antonio-Garcia-Filho, Lagarto, Sergipe, Brazil.

Department of Medicine, Federal University of Sergipe, Aracaju, Sergipe, Brazil.

出版信息

Neurochirurgie. 2023 Sep;69(5):101472. doi: 10.1016/j.neuchi.2023.101472. Epub 2023 Jul 22.

Abstract

Juvenile xanthogranuloma (JXG) is a rare type of non-Langerhans cell histiocytosis. Its systemic form affects 4% of patients. Lesions in the Central Nervous System (CNS) occur in 2% of systemic cases. Sellar JXG should be one of the differential diagnoses for sellar lesions in young. This is a 15-year-old patient with non-specific headache, progressive visual loss and magnetic resonance imaging showing sellar lesion with suprasellar extension. The patient underwent microsurgery by pterional craniotomy with partial resection of the tumor. Pathology evidenced JXG. It progressively evolved with impairment of neuroendocrine functions, new lesions in different CNS locations and death two years after diagnosis. Sellar JXG without cutaneous manifestations is rare. There are no specific findings of the disease. Diagnosis requires additional tests, being defined by pathological analysis. Total resection presents a greater potential control comparing to partial resection. Even so, some patients may have progressive disease with poor clinical outcome.

摘要

幼年黄色肉芽肿(JXG)是一种罕见的非朗格汉斯细胞组织细胞增生症。其全身型占所有患者的 4%。中枢神经系统(CNS)受累占全身型的 2%。鞍内 JXG 应是年轻人鞍区病变的鉴别诊断之一。这是一名 15 岁的患者,表现为非特异性头痛、进行性视力丧失,磁共振成像显示鞍内病变伴鞍上扩展。患者接受了翼点开颅术的显微手术,部分切除了肿瘤。病理证实为 JXG。它逐渐进展,伴有神经内分泌功能障碍、CNS 不同部位出现新病变,并在诊断后两年死亡。无皮肤表现的鞍内 JXG 较为罕见。该疾病没有特定的影像学表现。诊断需要进行额外的检查,通过病理分析来确定。与部分切除相比,全切有更大的潜在控制能力。即便如此,一些患者可能会出现疾病进展,临床结局较差。

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