García-Pravos A, Gelabert M, Arias M D, González J, Rumbo R M
Servicio de Neurocirugía, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, España.
Rev Neurol. 1998 Jan;26(149):74-6.
Meningiomas are benign tumours which originate in the arachnoid layer and are characterized by being iso- or hyper-dense on computerized axial tomography (CAT). Hypodense meningiomas are relatively infrequent and normally behave thus because of their fat content. A hypomeningioma is almost entirely composed of adipose tissue. However, a meningiotheliomatous meningioma with fatty degeneration, which is the case being considered, is characterized by zones of meningiotheliomatous cells together with zones of adipocytes.
We present the case of a 73 year old woman with a meningiotheliomatous meningioma with extensive fatty degeneration which on CAT scan showed as a hypodense lesion, with well-defined edges, which took up contrast heterogeneously and produced a hyperosfosant reaction. On magnetic resonance (RMN) it gave signals of heterogeneous intensities. Up to the present time, only four cases of pure lipomeningiomas have been described in the literature.
However, meningiomas with fatty degeneration are much more frequent. In this paper we discuss aspects of the differential diagnosis of meningiomas which behave as hypodense lesions on CAT scans.
脑膜瘤是起源于蛛网膜层的良性肿瘤,在计算机断层扫描(CAT)上表现为等密度或高密度。低密度脑膜瘤相对少见,通常因其脂肪含量而表现如此。低脂肪脑膜瘤几乎完全由脂肪组织组成。然而,本文所讨论的病例是一个伴有脂肪变性的脑膜皮型脑膜瘤,其特征是存在脑膜皮细胞区域和脂肪细胞区域。
我们报告一例73岁女性患者,患有广泛脂肪变性的脑膜皮型脑膜瘤,CAT扫描显示为低密度病变,边界清晰,不均匀摄取造影剂并产生高磷反应。在磁共振成像(MRI)上,它呈现出不均匀强度的信号。到目前为止,文献中仅描述了4例纯脂肪瘤型脑膜瘤。
然而,伴有脂肪变性的脑膜瘤更为常见。在本文中,我们讨论了在CAT扫描上表现为低密度病变的脑膜瘤的鉴别诊断方面。