脑胶质瘤病附3例报告

Gliomatosis Cerebri: Report on 3 Cases

脑胶质瘤病较为少见,临床诊断困难。本文结合作者收治的3例观察脑胶质瘤病的临床、病理、MRI特征,探讨本病确诊的方法。方法:对高度怀疑脑胶质瘤病患者3例进行脑组织活检,将临床症状、影像学特点及病理特点进行分析。结果:3例患者有进行性加重的头痛、呕吐等颅内压力增高表现,并伴有智能与精神障碍、癫痫、偏瘫等症状。影像学显示双侧大脑半球对称性弥漫性病灶,灰白质均受累,占位效应不明显,没有显著强化,病理证实为脑胶质瘤病。肿瘤细胞在大脑半球灰白质中广泛增殖,主要在血管、神经元周围呈浸润性生长,不形成团块。结论:脑胶质瘤病的临床表现与影像学结合可帮助诊断,最终确诊仍需依靠病理学检查。

BACKGROUND & OBJECTIVE: Gliomatosis cerebri(GC) is not common. This paper was to report on 3 cases and to analyze the clinicopatholigical characteristics and MRI features of CC. METHODS: Three cases of GC treated in our hospital were analyzed by reviewing clinical data, radiological manifestations as well as pathological sections. RESULTS: All cases had symptoms of raised intracranial pressure, such as progres-sive headache and vomiting. There were associated deterioration in mental function, dementia, epilepsy, and hemipare-sis. CT scan showed only slightly abnormal changes while MRI revealed diffuse lesions in both hemispheres with-out formation of a tumor mass. Histological examination showed the tumor had diffuse infiltration into both cerebral hemispheres with perineuronal and perivascular collection. The underlying neuronal architecture was still pre-served. CONCLUSION: The clinical and radiological features are helpful in making the diagnosis of GC. Howev-er confirmation requires brain biopsy.