颅内恶性黑色素瘤误诊为结核性脑膜炎1 例
| 作者: |
1陈娟,
2梁玉梅,
1王卫
1 解放军第309医院神经内科，北京 100091 2 解放军第309医院病理科，北京 100091 |
| 通讯: |
王卫
Email: 13910581521@163.com |
| DOI: | 10.3978/j.issn.2095-6959.2018.09.037 |
摘要
原发性颅内恶性黑色素瘤是罕见病例，目前国内外报道多为个案报道。现报告1例解放军第309医院结核科收治疑似结核性脑膜炎的病例，早期以头痛等颅内高压症状为表现，发热不明显，腰椎穿刺脑脊液表现类似结核性脑膜炎，影像学表现为广泛脑膜受累强化、伴局部脑实质受累，抗结核治疗效果不佳，临床症状不断恶化，手术活检后病理证实为恶性黑色素瘤。对疑似(特别是无明显发热史和抗生素疗效不佳)的临床酷似感染性脑膜炎的病例，应尽早行脑脊液细胞学检查，并反复送检以提高其阳性率。
关键词：
脑膜黑色素瘤；结核性脑膜炎；原发脑膜恶性黑色素瘤
A case of intracranial malignant melanoma misdiagnosed as tuberculous meningitis
CorrespondingAuthor: WANG Wei Email: 13910581521@163.com
DOI: 10.3978/j.issn.2095-6959.2018.09.037
Abstract
Primary intracranial malignant melanoma is a rare case. A case hospitaled in our tuberculosis department was suspected of tuberculous meningitis, early was performed with intracranial hypertension symptoms such as headache, fever was not obvious, cerebrospinal fluid showed similar tuberculous meningitis, imaging findings for extensive intensive meningeal involvement, with local parenchymal involvement. After anti-tuberculosis treatment, clinical symptoms were worsening, pathology confirmed as malignant melanoma after surgical biopsy. No obvious history of fever and poor antibiotics efficacy for suspected of clinical resembles infectious cases of meningitis, should resort to cerebrospinal fluid cytology check as soon as possible, and repeatedly inspection in order to improve the positive rate.
Keywords：
meningeal melanoma; tubercular meningitis; primary meningeal malignant melanoma