Terheggen H G
Monatsschr Kinderheilkd. 1985 Jan;133(1):13-9.
Incidentally CNS tumours may simulate acute bacterial or viral meningitis, cerebral abscess, and tuberculous or luetic basal meningitis. 64 cases from the literature are analysed together with 2 personal observations. This form of presentation is found most frequently in high-grade malignancy, i.e. in glioblastoma, medulloblastoma and ependymoma. In the group of benign CNS neoplasms dermoid and epidermoid cysts are most often associated with the meningeal syndrome. The only criterion facilitating a differentiation between acute bacterial meningitis and CNS malignancy is CSF culture. In individual cases an afebrile course, a normal sedimentation rate, and a normal WBC count may help to differentiate. In the presence of basal meningitic or diencephalic symptoms related to a prolonged course discrimination between brain tumour an tuberculous or luetic meningitis may become extremely difficult. In these cases the determination of creatine kinase BB isoenzyme and carcinoembryonic antigen in CSF may overcome the difficulty.
偶然情况下，中枢神经系统肿瘤可能类似急性细菌性或病毒性脑膜炎、脑脓肿以及结核性或梅毒性基底脑膜炎。对文献中的64例病例以及2例个人观察病例进行了分析。这种表现形式最常见于高级别恶性肿瘤，即胶质母细胞瘤、髓母细胞瘤和室管膜瘤。在良性中枢神经系统肿瘤组中，皮样囊肿和表皮样囊肿最常与脑膜综合征相关。有助于区分急性细菌性脑膜炎和中枢神经系统恶性肿瘤的唯一标准是脑脊液培养。在个别病例中，无发热病程、正常的血沉率和正常的白细胞计数可能有助于鉴别。当存在与病程延长相关的基底脑膜炎或间脑症状时，区分脑肿瘤与结核性或梅毒性脑膜炎可能极其困难。在这些情况下，测定脑脊液中的肌酸激酶BB同工酶和癌胚抗原可能会克服这一困难。
