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[神经胶质瘤被疱疹病毒污染]

[Contamination of a glioma by the herpes virus].

作者信息

Ochsner F

出版信息

Schweiz Arch Neurol Neurochir Psychiatr. 1981;129(1):19-30.

PMID:7313592
Abstract

The clinical and neuropathologic descriptions of a glioma in a 65 years old patient, who died 9 days after its subtotal resection, are documented. The post-mortem study of the brain revealed an herpetic encephalitis with its classical topographical distribution. There were numerous eosinophilic inclusion bodies which ultrastructurally were characteristic of herpes simplex virus. The author discusses, with reference to the literature, the exo and endogenous sources of infection, the means of dissemination, the problem of latency and reactivation of the virus. He proposes the hypothesis that the infection of the glioma cells is this case was most likely related the immature immunity of the cells, corticoid therapy and surgical resection acting as inducers. The almost complete absence of an inflammatory reaction evokes an opportunistic viral infection in an immunodeficient patient. Inspite of the description by many authors of different particles which have been interpreted as of viral origin in some brain tumours, the hypothesis of an oncogenic action of the herpetic virus is not retained in this particular case, considered as exceptional, of the glioma described herein. The precocious search for HSV antibodies by immunofluorescence and a temporal lobe biopsy in order to establish an early diagnosis are necessities so as to administer as rapidly as possible the specific therapy, adénine-arabinoside.

摘要

记录了一名65岁患者的胶质瘤临床和神经病理学描述,该患者在次全切除术后9天死亡。对大脑的尸检研究显示为具有典型地形分布的疱疹性脑炎。有许多嗜酸性包涵体,超微结构上具有单纯疱疹病毒的特征。作者参考文献讨论了感染的外源性和内源性来源、传播途径、病毒潜伏和再激活问题。他提出假说,在该病例中胶质瘤细胞的感染很可能与细胞的免疫不成熟、皮质类固醇治疗和手术切除作为诱导因素有关。几乎完全没有炎症反应提示免疫缺陷患者发生了机会性病毒感染。尽管许多作者描述了在一些脑肿瘤中被解释为病毒起源的不同颗粒,但在本文所述的这种特殊的胶质瘤病例中,疱疹病毒致癌作用的假说未被采纳。通过免疫荧光法尽早检测HSV抗体并进行颞叶活检以建立早期诊断,以便尽快给予特异性治疗——阿糖腺苷,这是必要的。

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