面部肉芽肿性感染合并颅内占位病变1例

A Case of Facial Granulomatous Infection Combined with Intracranial Mass Lesion

患者女,61岁。面部浸润性红斑2年,头晕、右侧肢体乏力半个月。皮肤科情况:鼻部、眶周、面颊以鼻梁为中心的大片蝶状暗红色浸润性皮损。组织病理结合免疫组化示:感染性肉芽肿改变,主要为浆细胞、淋巴和组织细胞浸润,考虑炎症性病变,伴浆细胞浸润。头颅MRI示:左侧顶叶占位,两侧额窦、筛窦、上颌窦炎症。诊断:面部肉芽肿性感染合并颅内占位病变。手术切除占位病变后,给予药物联合治疗,1个月后皮损基本消退。

A 61-year-old female had infiltrated erythematous plaques on the face for 2 years; she also had dizziness and right-limb weakness for half a month. Skin examination showed the lesion were infiltrated erythematous plaques on nasal,periorbital and buccal regions,The histopathological and immunohistochemical examinations showed non-specific infectious chronic granulomas,with a large number of lymphocytes,plasmacytes and histiocytes infiltration in the dermis. Brain MRI showed that the left parietal lobe had an occupying lesion,the bilateral frontal sinus,ethmoidal sinus and maxillary sinus showed inflammatory changes. Histopathological and immunohistochemical examinations of the left parietal lobe occupying lesion showed inflammatory changes with plasmacytes infiltration,the diagnosis was facial granulomatous infection combined with intracranial mass lesion. The patients was cured with surgical resection combined four-kinds of drugs therapy for one month. The skin lesion subsided significantly.