Fukazawa T, Yanagihara T, Hamada K, Hamada T
Hokuyukai Neurology Hospital, Sapporo, Japan.
J Neurol Neurosurg Psychiatry. 1994 Aug;57(8):980-2. doi: 10.1136/jnnp.57.8.980.
A 55 year old woman with multifocal eosinophilic granuloma (MEG) is described. She developed facial numbness and twitching followed by slowly progressive cerebellar symptoms. Two years later polyuria and polydipsia were noted. A CT of the brain showed multifocal enhancing lesions, and MRI showed areas of hyperintensity on T2 weighted studies in the cerebellar peduncles, pons, and midbrain. Radiographs of the skull, pelvis, and long bones were normal, but a 99mTc diphosphonate bone scan and MRI showed bone lesions compatible with granuloma. The diagnosis of MEG was made by bone biopsy. This is believed to be the first case of MEG with such unusual clinical profiles and radiographical findings. Skeletal surveys are indicated for patients with unexplained focal or multifocal inflammatory changes in the cerebellum.
本文描述了一名55岁患有多灶性嗜酸性肉芽肿（MEG）的女性。她出现面部麻木和抽搐，随后出现缓慢进展的小脑症状。两年后，出现多尿和烦渴。脑部CT显示多灶性强化病变，MRI显示小脑脚、脑桥和中脑在T2加权成像上有高信号区。颅骨、骨盆和长骨的X线片正常，但99mTc二膦酸盐骨扫描和MRI显示与肉芽肿相符的骨病变。通过骨活检确诊为MEG。据信这是首例具有如此不寻常临床特征和影像学表现的MEG病例。对于小脑出现不明原因局灶性或多灶性炎症改变的患者，建议进行骨骼检查。
