双语病例孤立性肿瘤样脱髓鞘病变

朗读老师：医院

审校老师：朱医院

History:A44-year-oldmanpresentedwithaseveral-weekhistoryofworseningdysarthriaandrightupperextremityweakness.

病史：男，44岁，因构音障碍和右上肢无力加重数周就诊。

AnunenhancedCTscanoftheheadwasperformed.Clickontheimagesbelowtoenlarge.

患者进行了头部CT平扫检查。点击下面的图片以放大。

MR图像

AbrainMRIwasperformed.AxialT1,T1postcontrast,T2,fluid-attenuatedinversion-recovery(FLAIR),diffusion-weighted(DWI),andapparentdiffusioncoefficient(ADC)imagesareshown.Inaddition,dynamicsusceptibilityweightedperfusionimagingwasperformed,whichisshownbelowfusedtoapostcontrastT1-weightedsequence.Clickontheimagestoenlarge.

患者进行了颅脑MRI检查，包括轴位T1、T1增强、T2、液体衰减反转恢复(FLAIR)、弥散加权(DWI)和表观弥散系数(ADC)序列。此外，患者还进行了动态磁敏感加权灌注成像检查，与T1增强序列融合的图像如下图所示。点击图片以放大。

Astereotacticbiopsywasperformed.Pathologywasconsistentwithanacutedemyelinatinglesionasmaybeseeninmultiplesclerosis,includingtumefactivemultiplesclerosis.Asthispatienthadnohistoryofmultiplesclerosis,thefinaldiagnosiswastumefactivedemyelinatinglesion(TDL).

患者进行了立体定向活检。病理结果支持急性脱髓鞘病变，如多发性硬化症，包括肿瘤样多发性硬化。由于该患者没有多发性硬化病史，最终诊断为肿瘤样脱髓鞘病变(TDL)。

结果和诊断

Findings

结果

HeadCT:CTshowsalargeareaofhypoattenuationintheleftfrontallobewithpreservedgray-whitedifferentiation.Thereisslightmasseffectmanifestedbysulcaleffacementandminimal

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