一个诊断陷:逆神经膜瘤
On Wa Ng1, Fung Him Ng1, Yuen Fun Mak2
1Diagnostic and Interventional Radiology Department, Princess Margaret Hospital, Kowloon West Cluster, Hong Kong, HKG.
Cureus
|November 27, 2025
概括
一个最初被怀疑是转移性结肠直肠癌的瘤被诊断为一次性神经膜瘤. 这一案例强调了FDG-avid病变的组织诊断在有恶性瘤病史的患者中的重要性.
科学领域:
- 在瘤学瘤学.
- 放射学 放射学是一门学科.
- 病理学 病理学 病理学
背景情况:
- 一名78岁的女性患有切除的结直肠腺癌,呈现出癌胚抗原 (CEA) 水平的上升.
- 图像检测显示出一种氧葡萄糖 (FDG) 激发的逆性病变,可疑为转移性疾病.
研究的目的:
- 研究患有恶性瘤病史的患者中FDG-avid病变的诊断挑战.
- 突出考虑罕见的差异诊断和追求组织诊断的重要性.
主要方法:
- 阳位子辐射断层扫描/计算机断层扫描 (PET-CT) 用于病变的表征.
- 对于怀疑转移性疾病的立体性身体放射疗法.
- 活检和免疫组织化学染色 (SOX10,S100) 用于确定诊断.
主要成果:
- 尽管进行了治疗,但病变仍然存在,略微扩大,CEA持续升高.
- 活检显示了一个状细胞瘤.
- 免疫组织化学证实了主要的神经瘤,而不是转移性结肠直肠癌.
结论:
- 患有先前恶性瘤的患者的FDG-avid病变可能会带来诊断挑战.
- 尽管治疗,瘤标志物的持续升高和病变的生长需要进一步调查.
- 组织诊断对于区分转移性疾病与神经膜瘤等罕见的初级瘤至关重要.
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