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中华脑血管病杂志(电子版) ›› 2022, Vol. 16 ›› Issue (03) : 206 -209. doi: 10.11817/j.issn.1673-9248.2022.03.012

病例报告

肿瘤样原发性中枢神经系统血管炎一例
何玲1, 饶明俐1, 曲瑒1, 靳航1,()   
  1. 1. 130021 长春,吉林大学第一医院卒中中心
  • 收稿日期:2022-02-21 出版日期:2022-06-01
  • 通信作者: 靳航
  • 基金资助:
    国家自然科学基金面上项目(81971109)

Tumor-like primary angiitis of the central nervous system (PACNS): a case report

Liang Li1   

  • Received:2022-02-21 Published:2022-06-01
引用本文:

何玲, 饶明俐, 曲瑒, 靳航. 肿瘤样原发性中枢神经系统血管炎一例[J]. 中华脑血管病杂志(电子版), 2022, 16(03): 206-209.

Liang Li. Tumor-like primary angiitis of the central nervous system (PACNS): a case report[J]. Chinese Journal of Cerebrovascular Diseases(Electronic Edition), 2022, 16(03): 206-209.

图1 头部磁共振检复查可见左侧小脑半球、小脑蚓部、左侧桥脑及右侧颞叶团片状异常信号,异常信号在T1加权成像(图a、b)及T2加权成像(图c、d)呈高及等信号,液体抑制反转恢复序列(图g)在低信号背景下有片状高信号,弥散加权成像(图e、f)可见弥散受限,增强扫描(图h)可见异常信号区不规则强化影
图2 3个月前外院头部磁共振检查可见左侧小脑半球肿块占位,信号不均匀(图a、b、c分别为T1加权、T2加权、液体抑制反转恢复序列图像);弥散加权成像序列(图d)可见病灶轻度弥散受限;增强扫描呈不规则强化(图e);磁共振血管造影(图f)显示颅内大血管走行清晰、未见异常
图3 肿瘤样原发性中枢神经系统血管炎病理图。病理切片(图a、b、c分别为4倍镜、10倍镜、40倍镜下HE染色)可见小脑组织广泛坏死,蛛网膜下腔及脑实质内部分血管管壁增厚,管壁间可见淋巴细胞浸润,个别血管壁呈纤维素样坏死,个别血管管腔闭塞,血管周围散在灶性淋巴细胞及吞噬细胞浸润。免疫组织化学检测(图d、e、f均为×100):CD3(+)(图d),CD68(+)(图e),Ki67(<1%+)(图f)
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