质母细胞瘤的自身免疫性脑炎样呈现:了解这个罕见的情况
Alberto Negro1, Vincenzo D'Agostino1, Eugenio Maria Covelli2,3
1Neuroradiology Unit, Ospedale del Mare, via Enrico Russo, 80147 Naples, Italy.
Journal of clinical medicine
|June 13, 2025
概括
质母细胞瘤 (GBM) 可以模仿自身免疫性脑炎 (AE),延迟诊断和治疗. 早期成像和活检对于非典型病例至关重要,以排除恶性瘤并确保及时管理.
科学领域:
- 神经学 神经学
- 在瘤学瘤学.
- 神经免疫学 神经免疫学
背景情况:
- 质母细胞瘤 (GBM) 是一种具有不良预后的侵袭性原发性脑瘤.
- GBM可能会出现重叠的自身免疫性脑炎 (AE) 症状,导致诊断延迟.
- 共同的临床,放射学和血清学发现需要仔细区分.
研究的目的:
- 调查最初被误诊为AE的GBM病例.
- 突出这些病例的诊断挑战和延迟.
- 强调早期恶性瘤排除的重要性.
主要方法:
- 病理确认的GBM病例 (2016-2023) 的回顾性审查,最初怀疑是AE.
- 诊断工作的分析包括MRI,CSF分析,自身抗体测试和全身扫描.
- 根据最终的病理学,对最初的诊断进行批判性重新评估.
主要成果:
- 五名GBM女性患者最初呈现出AE类症状.
- 最初的MRI和CSF发现往往是不具体的或误导性的.
- 由于AE模拟导致诊断延迟导致预后不佳 (平均存活时间为10±4个月).
结论:
- 质母细胞瘤可以伪装成自身免疫性脑炎,影响治疗时间表.
- 非典型的MRI发现和治疗反应不佳,需要及早考虑恶性瘤.
- 多学科评估和及时活检对于准确的GBM诊断至关重要.
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