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NEJM:蝴蝶状胶质瘤-病例报道

2018-01-18 xing.T MedSci原创

对扩展到胼胝体和对称额叶病变的鉴别诊断包括胶质母细胞瘤和原发性中枢神经系统淋巴瘤。右额叶活检显示为胶质母细胞瘤。

患者为一名83岁的女性,因左侧手臂无力、右侧脸部下垂、口齿不清和尿失禁5小时而到急诊就诊。就诊时报告既往周内有一个渐进的认知功能下降。

头部钆增强磁共振成像(MRI)显示为一个实体增强的T1加权序列上的病变,蝶形出现在胼胝体上(如图A所示)。在T2加权序列可观察到高信号肿块(如图B所示),并且在限制扩散弥散加权的MRI可观察到。




对扩展到胼胝体和对称额叶病变的鉴别诊断包括胶质母细胞瘤和原发性中枢神经系统淋巴瘤。右额叶活检显示为胶质母细胞瘤。

在讨论了有限的治疗方案,包括放疗和化疗后,对于这种广泛的肿瘤,该患者和家属选择了支持性的姑息治疗。病人于3周后死亡。

原始出处:

Juveria Siddiqui, et al. Butterfly Glioma.N Engl J Med 2018. http://www.nejm.org/doi/full/10.1056/NEJMicm1704713

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  1. [GetPortalCommentsPageByObjectIdResponse(id=1650556, encodeId=e64516505569b, content=<a href='/topic/show?id=892588848b9' target=_blank style='color:#2F92EE;'>#蝴蝶状胶质瘤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=88848, encryptionId=892588848b9, topicName=蝴蝶状胶质瘤)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d98724025622, createdName=sunyl15, createdTime=Sat Sep 08 22:46:00 CST 2018, time=2018-09-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=279650, encodeId=57e02e9650f8, content=谢谢分享.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=120, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Thu Jan 18 09:09:55 CST 2018, time=2018-01-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=279629, encodeId=15012e9629eb, content=学习了新知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201006/4db877c2887649beb09cb5effd0b38c7/916f66edd48a4e77b20ebc3e14b6e45c.jpg, createdBy=141e1980133, createdName=Y—xianghai, createdTime=Thu Jan 18 08:21:53 CST 2018, time=2018-01-18, status=1, ipAttribution=)]
  2. [GetPortalCommentsPageByObjectIdResponse(id=1650556, encodeId=e64516505569b, content=<a href='/topic/show?id=892588848b9' target=_blank style='color:#2F92EE;'>#蝴蝶状胶质瘤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=88848, encryptionId=892588848b9, topicName=蝴蝶状胶质瘤)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d98724025622, createdName=sunyl15, createdTime=Sat Sep 08 22:46:00 CST 2018, time=2018-09-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=279650, encodeId=57e02e9650f8, content=谢谢分享.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=120, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Thu Jan 18 09:09:55 CST 2018, time=2018-01-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=279629, encodeId=15012e9629eb, content=学习了新知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201006/4db877c2887649beb09cb5effd0b38c7/916f66edd48a4e77b20ebc3e14b6e45c.jpg, createdBy=141e1980133, createdName=Y—xianghai, createdTime=Thu Jan 18 08:21:53 CST 2018, time=2018-01-18, status=1, ipAttribution=)]
    2018-01-18 明月清辉

    谢谢分享.学习了

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  3. [GetPortalCommentsPageByObjectIdResponse(id=1650556, encodeId=e64516505569b, content=<a href='/topic/show?id=892588848b9' target=_blank style='color:#2F92EE;'>#蝴蝶状胶质瘤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=88848, encryptionId=892588848b9, topicName=蝴蝶状胶质瘤)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d98724025622, createdName=sunyl15, createdTime=Sat Sep 08 22:46:00 CST 2018, time=2018-09-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=279650, encodeId=57e02e9650f8, content=谢谢分享.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=120, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Thu Jan 18 09:09:55 CST 2018, time=2018-01-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=279629, encodeId=15012e9629eb, content=学习了新知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201006/4db877c2887649beb09cb5effd0b38c7/916f66edd48a4e77b20ebc3e14b6e45c.jpg, createdBy=141e1980133, createdName=Y—xianghai, createdTime=Thu Jan 18 08:21:53 CST 2018, time=2018-01-18, status=1, ipAttribution=)]
    2018-01-18 Y—xianghai

    学习了新知识

    0

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