Nishioka H, Ito H, Miki T
Department of Neurosurgery, Tokyo Medical College, Japan.
Br J Neurosurg. 1996 Feb;10(1):103-7. doi: 10.1080/bjn.10.1.103.
A 46-year-old woman presented with a 2-month history of right hemiparesis and disorientation. CT showed only slightly abnormal findings, while the T2-weighted MRI findings disclosed high intensity in both hemispheres. Two weeks before her death, a biopsy specimen showed monotonous increase of gemistocyte-like cells, mimicking reactive gliosis. However, autopsy revealed some different cytological features; i.e. nuclear atypia and higher cellularity, and the diagnosis of gliomatosis cerebri was made. It is suggested that establishing an antemortem diagnosis of gliomatosis cerebri remains difficult in some cases, even with MRI and biopsy. Careful examination of autopsy material may be necessary for a definitive diagnosis.
一名46岁女性，有2个月的右侧偏瘫和定向障碍病史。CT仅显示轻微异常，而T2加权MRI结果显示双侧大脑半球高强度信号。在她去世前两周，活检标本显示类似肥胖星形细胞的细胞呈单调增加，类似反应性胶质增生。然而，尸检发现了一些不同的细胞学特征，即核异型性和更高的细胞密度，最终诊断为大脑胶质瘤病。这表明，即使有MRI和活检，在某些情况下，生前诊断大脑胶质瘤病仍然困难。为了明确诊断，可能需要仔细检查尸检材料。
