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

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We clinicopathologically analyzed 12 cases who were initially diagnosed as malignant brain tumor, but weredifficult to diagnose after surgery. Finally, 4 cases were diagnosed as malignant brain tumors, and 8 as nonneoplasticdisease. By unusual clinical course, four patients were changed their preoperative diagnosis to nonneoplsticdisease and surgery was performed to rule out tumor. Craniotomies were performed in 9cases, andstereotactic biopsies in 3. In five cases, inflammatory changes were seen and we diagnosed these cases asmultiple 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 diagnosticyield 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 inflammatoryprocesses without histopathological examintaion. There has been no patient whose diagnosis changedagain due to clinical course after treatments. These results suggested that if surgical specimen had sufficientpathological yields, they bring us some clues to decide clinical diagnosis and exact treatment strategy.
近畿脳腫瘍病理検討会の論文