Nonneoplastic intramedullary spinal cord lesions mimicking tumors
Nonneoplastic intramedullary spinal cord lesions mimicking tumors
复制标题
DOI：
10.1097/00006123-199810000-00034
复制
发表时间：
1998-10-01
期刊：
影响因子：
4.8
通讯作者：
Zagzag, D
中科院分区：
文献类型：
--
作者：
Lee, M;Epstein, FJ;Zagzag, D
目的：我们报告了一组9例非典型、非肿瘤性脊髓髓内病变的患者。通过回顾性回顾这些患者，我们希望在手术干预前阐明这些患者是否存在非肿瘤性病变的特征。方法：我们回顾了1989年至1994年间接受脊髓髓内肿瘤手术的212例患者的组织学表现。我们确定了9例非肿瘤性病变患者（4%）；回顾了病例史和x光片。结果：所有患者术前均行磁共振成像评估。钆强化的程度从均匀强化到无强化不等。所有病变均有明显的T2改变。所有病例的病变均缺乏明显的脊髓扩张。所有患者均接受手术治疗。手术标本的组织学显示4例患者有脱髓鞘病变，2例患者有结节病，2例患者有淀粉样血管病，1例患者有不明来源的非肿瘤性炎症细胞团块。结论：虽然术前病史和体格检查很难将这些病变与脊髓肿瘤性肿瘤区分开来，但术前磁共振图像上没有或只有极小的脊髓扩张是最一致的线索。
OBJECTIVE: We report a group of nine patients with atypical, nonneoplastic intramedullary spinal cord lesions. By retrospectively reviewing these patients, we hoped to elucidate characteristics that would identify these patients as harboring nonneoplastic lesions before surgical intervention.METHODS: We reviewed the histological findings of 212 patients undergoing surgery for intramedullary spinal cord tumors between 1989 and 1994. We identified nine patients with nonneoplastic lesions (4%); case histories and radiographs were reviewed.RESULTS: All patients were evaluated preoperatively using magnetic resonance imaging. The extent of enhancement with gadolinium varied from homogeneous enhancement to no enhancement. All lesions showed marked T2 changes. There was a lack of significant spinal cord expansion associated with the lesions in ail cases. All patients underwent surgery. The histology of the surgical specimens showed demyelinating lesions in four patients, sarcoidosis in two patients, amyloid angiopathy in two patients, and a mass of nonneoplastic inflammatory cells of unknown origin in one patient.CONCLUSION: Although it was difficult to antecedently distinguish these lesions from neoplastic spinal cord tumors by case history and physical examination, the most consistent clue was absent or minimal spinal cord expansion on the preoperative magnetic resonance images.