脑炎性假瘤的临床、影像学及病理特征(附1例报告)

Clinical, imaging and pathological features of intracerebral inflammatory pseudotumour (report of 1 case)

目的探讨脑炎性假瘤的临床、影像学及病理特征。方法回顾性分析1例脑炎性假瘤患者的临床资料。结果本例脑炎性假瘤患者临床表现为头痛、恶心、呕吐、发热、抽搐发作等,头部MRI显示右侧额叶大片长T1、长T2信号,中线移位。病理检查可见脑组织肿胀,正常神经元轮廓消失,血管周围大量炎细胞浸润。经手术、脱水、抗感染等治疗无效,死亡。结论脑炎性假瘤病例少见,临床表现和影像学改变无特异性;病理学检查是诊断的主要依据;本病手术治疗效果不好。

Objective To investigate the clinical, imaging （CT and MRI ） and pathological features of intracerebral inflammatory pseudotumour. Methods The clinical, neuroimaging and neuropathological data of a patient with intracerebral inflammatory pseudotumour were analyzed retrospectively. Results The manifestations of this patient included headache, nausea, vomiting, fever and seizures. Brain MRI showed abnormal high T1 and T2 signals in the right frontal lobe and midline shift. The resection pathology showed brain tissue swelling, loss of normal neuron outline, massive inflammatory infiltrations in perivascular spaces. Although the patient was treated with operation, dehydration and antibiotics, he died eventually. Conclusions Intracerebral inflammatory pseudotumour is an unusual disease in clinical practice. This disease is diagnosed mainly depended upon pathological examinations because of no specific clinical and imaging manifestations. The prognosis is not good although operative treatment is performed.