脑膜恶性黑色素瘤的诊断:1例报告

Clinical analysis of meningeal malignant melanoma:an analysis of 1 case

目的探讨中枢神经系统黑色素瘤的临床诊断方法。方法结合文献报道,分析1例脑膜恶性黑色素瘤患者的临床表现、实验室检查、影像学检查和预后情况。结果该例黑色素瘤临床表现无特征性,病变侵及脑膜,MR I表现为脑室梗阻、脑积水。脑脊液外观呈黄色,压力升高,白细胞增高,蛋白增高,全片镜检可见细胞胞体较大,呈圆形,核染质较粗,核仁呈蓝色,胞浆染色为灰蓝色,胞浆内有褐色黑色素颗粒,胞浆膜周围有花边状小空泡环绕。结论脑脊液细胞学检查是确诊脑膜恶性黑色素瘤的主要依据。

Objective To explore clinical diagnosis method of central nervous system melanoma. Methods The recent literature was revived to analyze and discuss the clinical manifestation, laboratory examinations, imaging manifestation and its prognosis in a patient with melanoma. Results The clinical manifestation in this case had no the characteristic appearance with the invasion of the meninges;the MRI performance was the ventricles obstruction and hydrocephalus. The color of cerebrospinal fluid was the yellow with increased pressure,the white blood cell count and the protein level;The cells body was larged and circular, chromatin was rough with the blue nucleole,the cell cytoplasm was stained for the gray - blue, brown melanin granule was discovered with many lace - shaped small vacuoles around cytoplasm membrane throughout the film on microscopy. Conclusion The cerebrospinal fluid cytology inspection is the main diagnose basis of discovering meningeal malignant melanoma.