PT -期刊文章盟-杰米Labuzetta盟Asheen罗摩AU -布莱恩Lemkuil盟Navaz李东华TI -神经胶质过多装扮成一个肉芽肿的过程(P4.225)的大脑DP - 2015年4月06 TA -神经病学PG - P4.225 VI - 84 IP - 14补充4099 - //www.ez-admanager.com/content/84/14_Supplement/P首页4.225.short 4100 - //www.ez-admanager.com/content/84/14_Supplement/P4.225.full所以Neurology2015 4月06;84 AB -背景:神经胶质过多大脑是一种罕见的原发性脑瘤的特点是弥漫性肿瘤浸润通常呈现在三或四年的生活。我们提出的神经胶质过多模仿一个肉芽肿的过程。案例:38岁的女人6 - 8周的特异性的背部疼痛和头痛被送至医院后发现没有响应。腰椎穿刺显示在1000红血球,45白细胞,蛋白质和总在1000年。MRI大脑显示多个领域的异常T2延长和弥漫性结节leptomeningeal增强。她有一个广泛的引起自身免疫(Anti-Ro /洛杉矶,安娜,anti-dsDNA anti-cardiolipin抗体,RNP, RF),肉芽肿(ANCA, ACE)、感染(脑炎面板、带状疱疹、艾滋病、包柔氏螺旋体、布鲁氏菌、HTLV,梅毒,Coccidiomycosis,痢疾,分枝杆菌,隐球菌,立克次氏体、弓形虫),脱髓鞘(寡克隆条带,anti-NMO MBP)、毒理学和多种(包括anti-NMDA)障碍。三个脑脊液细胞学和流式细胞术评估是不起眼的,就像CT胸部或腹部/骨盆。她的评价是显著的低水平的补充,阳性血清JC病毒,CSF白蛋白高,低CD4细胞计数(225)。她与大剂量强的松治疗经验,氨苄青霉素,头孢曲松钠,无环鸟苷,改善基线,出院回家后15天,并恢复正常的活动(如洗衣、做饭),虽然易疲劳性增加。 Unfortunately, she re-presented less than one week later with decreased oral intake, vomiting, and seizures. CT head revealed acute hydrocephalus. Repeat MRI brain revealed interval worsening of the nodular enhancement “consistent with granulomatous meningitis” and stable intraparenchymal T2 abnormality “suggestive of encephalitis”. MRI spine showed diffuse thoracolumbar nodular thickening and leptomeningeal enhancement. She underwent dural and optico-carotid lesion biopsies. The optico-carotid lesion revealed high-grade astrocytic tumor; she was diagnosed with gliomatosis cerebri. Her family elected to pursue a palliative course. She passed away less than 8 weeks after initial presentation. Conclusions: It is important to consider neoplastic etiologies in the differential of granulomatous processes, even when preliminary neoplastic evaluation is unremarkable.Disclosure: Dr. LaBuzetta has nothing to disclose. Dr. Rama has nothing to disclose. Dr. Lemkuil has nothing to disclose. Dr. Karanjia has nothing to disclose.Wednesday, April 22 2015, 7:30 am-12:00 pm