部神经的外骨髓性血细胞瘤:一个说明性的案例
Parsa Nilchian1, Max Reed1, Andrew B Yang1
1Department of Neurological Surgery, NewYork-Presbyterian Hospital/Weill Cornell Medicine, New York, New York.
Journal of neurosurgery. Case lessons
|January 22, 2026
概括
外骨髓性血细胞瘤 (EMP) 可以侵入周围神经,包括神经,在多发性骨髓瘤 (MM) 患者中是一种罕见的呈现. 在被怀疑是外围神经膜瘤 (PNSTs) 时,手术内活检对于诊断这些瘤至关重要.
科学领域:
- 在瘤学瘤学.
- 神经学 神经学
- 病理学 病理学 病理学
背景情况:
- 外骨髓性血细胞瘤 (EMP) 是一种罕见的血细胞瘤,通常影响头部和部.
- 在对外围神经膜瘤 (PNSTs) 的差异诊断中很少考虑EMP.
- 多发性骨髓瘤 (MM) 是一种源于骨髓的血细胞恶性瘤.
研究的目的:
- 报告一例罕见的外骨髓性血细胞瘤侵袭了多发性骨髓瘤患者的小腿神经.
- 强调在PNST的差异诊断中考虑EMP的重要性,特别是在MM患者中.
- 突出在疑似PNST与非典型成像发现的情况下,手术内活检的诊断效用.
主要方法:
- 一个70岁的女性MM患者的案例研究,表现为带神经疼痛和疑似PNST.
- 诊断成像,包括MRI,以表征尾中的病变.
- 手术切除尝试与手术内冷病理学分析.
- 手术后使用放射治疗和德克利斯塔马布进行治疗.
主要成果:
- 术内冷病理学揭示了一个具有高增殖活性的外骨髓性血细胞瘤,阻止了计划中的PNST切除.
- 瘤广泛包围着部神经,表现出透性和出血性特征.
- 患者耐受了辐射和teclistamab治疗,没有并发症.
结论:
- 这一病例代表了第一个涉及神经的外骨髓性血细胞瘤的记录实例.
- 应将EMP纳入PNST差异诊断,特别是在有多发性骨髓瘤病史的患者中.
- 术内活检对于准确诊断至关重要,当疑似PNST的成像发现不确切时.
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