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目的 观察瘤块型脱髓鞘病变的临床表现和病理特点 ,探讨其病理特征及发生原因。方法 对 3例瘤块型脱髓鞘病变的临床特点 ,CT、MRI所见 ,治疗效果及随访材料进行分析 ,并用组织学 (HE、髓鞘和轴索染色法 )及免疫组织化学SP法观察其病理学改变。结果 瘤块型脱髓鞘病变以急性起病为主 ,临床表现为头痛、恶心呕吐及神志恍惚、语言迟钝、瘫痪、病理征阳性等脑实质受损和脑局灶性定位的症状和体征。CT、MRI扫描为脑实质占位性病变。对激素治疗均有效。随访 6～ 31个月均未发现病情进展或复发。病理特点主要侵犯两侧大脑半球 ,病灶区域脑组织脱髓鞘 ,但轴索仍保留 ,星形胶质细胞增生 ,大量淋巴细胞在血管周围呈套袖样浸润 ,并可见单核巨噬细胞反应。结论瘤块型脱髓鞘病变是具有独特临床表现和病理形态特点的炎性疾病 ;其发生原因可能与病毒感染诱发的变态反应有关
Objective To observe the clinical manifestations and pathological features of tumor type demyelinating lesions and to explore its pathological features and causes. Methods The clinical features, CT findings, therapeutic effects and follow-up materials of 3 cases of lump-like demyelinating lesions were analyzed and analyzed by histology (HE, myelin sheath and axonal staining) and immunohistochemical SP method Its pathological changes. Results The majority of the lesions were acute onset. The clinical manifestations were headache, nausea, vomiting and delirium, speech retardation, paralysis, positive signs of brain damage and brain focal signs and symptoms. CT, MRI scan of the brain parenchyma lesions. Hormone therapy are effective. All patients were followed up for 6 to 31 months without any progression or recurrence of disease. Pathological features of the main violations of the bilateral hemispheres on both sides of the lesion area of brain demyelination, but the axonal remains, astrocyte proliferation, a large number of lymphocytes around the blood vessels in a sleeve-like infiltration and visible mononuclear macrophage response . Conclusions Nodular demyelinating lesions are inflammatory diseases with unique clinical manifestations and pathological features. Their causes may be related to the allergic reactions induced by virus infection