Clinicopathological Analysis of Patients with Non-diagnostic Biopsied Lesions in the Brain, -Differential Diagnosis between Brain Tumors and Other Diseases.

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  • 悪性脳腫瘍と非腫瘍性疾患との鑑別が困難であった症例に関する臨床的組織学的検討
  • アクセイ ノウシュヨウ ト ヒシュヨウセイ シッカン ト ノ カンベツ ガ コンナン デ アッタ ショウレイ ニ カンスル リンショウテキ ソシキガクテキ ケントウ

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Abstract

We clinicopathologically analyzed 12 cases who were initially diagnosed as malignant brain tumor, but were difficult to diagnose after surgery. Finally, 4 cases were diagnosed as malignant brain tumors, and 8 as nonneoplastic disease. By unusual clinical course, four patients were changed their preoperative diagnosis to nonneoplstic disease and surgery was performed to rule out tumor. Craniotomies were performed in 9cases, and stereotactic biopsies in 3. In five cases, inflammatory changes were seen and we diagnosed these cases as multiple sclerosis, vasculitis or encephalitis. In two cases, pathological findings supported cerebral infarction. There were no pathological findings in four cases, The reasons that surgical specimen did not give diagnostic yield were that they were too small or obtained from unappropriate resion. We also found malignant lymphoma, （especially intravascular lymphoma）is the most difficult to be distinguished from other disease such as inflammatory processes without histopathological examintaion. There has been no patient whose diagnosis changed again due to clinical course after treatments. These results suggested that if surgical specimen had sufficient pathological yields, they bring us some clues to decide clinical diagnosis and exact treatment strategy.

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