脑膜恶性黑色素瘤病脑脊液细胞学及神经影像学特点  

Cerebrospinal fluid lytology and neuroimaging features of menigeal malignant melanosis

作　　者：梁宪红[1] 申园[1] 关鸿志[2] 张在强[1] 

机构地区：[1]首都医科大学附属北京天坛医院神经内科病理实验室,北京100050 [2]中国医学科学院北京协和医学院北京协和医院神经内科,北京100730

出　　处：《癌症进展》2010年第5期519-522,共4页Oncology Progress

摘　　要：目的探讨脑膜恶性黑色素瘤病的临床、脑脊液细胞学及神经影像学特点。方法分析我院收治的3例脑膜恶性黑色素瘤病患者的临床表现、脑脊液细胞学检查结果以及神经影像学特点。结果 3例患者中女性2例,男性1例,均以全头胀痛、呕吐等高颅压症状起病,随后出现脑膜刺激征。行颅MRI检查均提示脑膜有广泛强化。腰穿可见脑脊液中有大量的异型细胞,呈簇或散在分布,胞体大小不一,胞膜不规则有突起,细胞质嗜碱性,细胞核深染。结论脑膜黑色素瘤病临床主要表现为头痛、呕吐等高颅压症状以及脑膜刺激征,如果脑脊液中发现有大量的异型肿瘤细胞,颅MRI提示有病灶以及脑膜明显强化,患者皮肤伴有黑痣,对脑膜黑色素瘤病的确定诊断都具重大的意义。Objective To investigate the cytologic and neuroimaging features of menigeal malignant melanosis. Methods The clinical manifestations, cytological examination, and neuroimaging results of three patients with menigeal malignant melanosis were analyzed. Results Three patients were found to have initial onsets of intracranial hyperpressure such as headache and vomiting, followed by meningeal irritation. Magnetic resonance imaging （MRI） of all 3 patients showed abnormal enhancement of meninge. There were numerous abnormal-shaped cells in CSF. They were clustered or scattered in different sizes. The membrane of tumor cell have irregular protuberance, with basophilla cytoplasm and anach- romasis cell nucleus. Conclusion The main clinical manifestations of meningeal malignant melanosis patients are in- tracranial hyperpressure such as headache and vomiting and meningeal irritation. There are plenty of abnormal shape tumor cells in CSF. MRI shows a tumor and abnormal enhancement of meninge. Patients usually have melanotic nevus on the skin. All these findings are valuable in the diagnosis of menigeal malignant melanosis.

关 键 词：脑膜肿瘤 黑色素瘤 脑脊液细胞学 磁共振成像 

分 类 号：R739.45[医药卫生—肿瘤]