Intramedullary tuberculoma mimicking primary CNS lymphoma
Intramedullary tuberculoma mimicking primary CNS lymphoma
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DOI：
10.1136/jnnp.2003.029926
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发表时间：
2004-11-01
影响因子：
11
通讯作者：
Rostomily, R
中科院分区：
文献类型：
--
作者：
Mohit, AA;Santiago, P;Rostomily, R
原发性中枢神经系统淋巴瘤（PCNSL）的发病率在免疫缺陷综合征（如获得性免疫缺陷综合征（AIDS））的背景下一直呈上升趋势。脑脊液（CSF）爱泼斯坦-巴尔病毒（EBV）PCR检测的出现促进了其诊断。该检测报告的高灵敏度和特异性使其成为PCNSL诊断的基石，取代了更传统的方法，如开放式CNS活检。在这里，我们已经描述了一个已知的病史的C3艾滋病表现为下肢无力和最终脊髓病谁后来被诊断为髓内PCNSL后，检测到EB病毒DNA在他的CSF。在对放射治疗无效后，他接受了脊髓活检，发现髓内结核瘤。该病例说明了使用该检测的误诊风险以及在实施治疗之前病理性病变的组织学确认的重要性。
The incidence of primary central nervous system lymphoma (PCNSL) has been on the rise in the setting of immunodeficiency syndromes such as acquired immune deficiency syndrome ( AIDS). Its diagnosis has been facilitated by the advent of a cerebrospinal fluid (CSF) Epstein - Barr virus (EBV) PCR assay. The reported high sensitivity and specificity of this assay has made it the cornerstone of diagnosis of PCNSL, replacing more traditional methods such as an open CNS biopsy. Here, we have described a patient with a known history of C3 AIDS presenting with lower extremity weakness and eventual myelopathy who was later diagnosed as having intramedullary PCNSL after detection of EBV DNA in his CSF. After failing to respond to radiotherapy, he underwent a spinal cord biopsy revealing intramedullary tuberculoma. This case illustrates the risk of misdiagnosis with this assay and the importance of histological confirmation of a pathological lesion prior to implementation of therapy.