首诊于神经眼科的血液系统肿瘤的临床及影像学特征

发布时间：2018-02-16 08:50

本文关键词： 视神经淋巴瘤骨髓瘤　出处：《眼科》2017年05期 　论文类型：期刊论文

【摘要】：目的分析首诊于神经眼科的血液系统肿瘤患者的临床及影像学特征。设计回顾性病例系列。研究对象2015年解放军总医院神经眼科诊治的3例以视神经病变为首发表现,最终病理确诊为血液系统肿瘤患者。方法回顾性分析患者的临床、影像、实验室检查及病理结果。主要指标临床表现、眼眶磁共振成像(MRI)、血液及脑脊液检测、骨髓及脑组织病理检查。结果3例患者年龄均50岁,其中2例首发症状为视力下降,1例双眼一过性黑w俏追⒅⒆础２±砝嘈头直鹞致驜细胞淋巴瘤、小B细胞型淋巴瘤、多发性骨髓瘤。眼眶MRI检查:2例淋巴瘤患者可见视神经增粗,伴不同程度强化;多发性骨髓瘤患者右侧视神经及视交叉呈长T2信号,未见明显强化。结论血液系统肿瘤以视神经病变首发极为少见,临床表现为类似视神经炎症状,血液检查及影像检查有利于辅助诊断,病理检查为确诊的金标准。
[Abstract]:Objective to analyze the clinical and imaging features of patients with hematological neoplasms first diagnosed in neuroophthalmology, and to design a retrospective series of cases. In 2015, 3 cases of neuroophthalmological diagnosis and treatment in PLA General Hospital were studied with optic neuropathy as the first manifestation. Methods the clinical, imaging, laboratory and pathological findings of the patients were retrospectively analyzed. The main clinical manifestations, orbital magnetic resonance imaging (MRI), blood and cerebrospinal fluid (CSF) detection were analyzed retrospectively. Results the age of the 3 patients was 50 years old. Pursue 1819 basis 2 卤phachaga straight Harrier? To? Small B-cell lymphoma, multiple myeloma, orbital MRI examination showed that the optic nerve was thickened in 2 cases with different degrees of enhancement, and the right optic nerve and optic chiasma showed long T 2 signal intensity in multiple myeloma patients. Conclusion the first occurrence of hematologic neoplasms is optic neuropathy, the clinical manifestations are similar to those of optic neuritis, blood examination and imaging examination are helpful for auxiliary diagnosis, and pathological examination is the golden standard for diagnosis.
【作者单位】：北京美尔目定慧医院神经眼科;解放军总医院眼科;昆明医科大学第二附属医院眼科;
【基金】：海南省社会发展科技专项项目(SF201424)
【分类号】：R733;R771.3

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