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TDL(Tumefactive demyelinating lesions)は2cm以上の炎症性脱髄性疾患と定義され,多発性硬化症などの経過中に出現し得るが,初発病変としてみられた場合には,鑑別が特に困難となる。腫瘍性,あるいは感染性疾患との鑑別のために,各種画像検査に加えて病理学的検討を要することも多い。本論では,TDLの概念,疫学,診断,治療について概論する。
Abstract
Tumefactive demyelinating lesions (TDL), defined as inflammatory demyelinating lesions, may develop either during treatment for multiple sclerosis and related disorders or as the first demyelinating episode without any past medical history suggesting demyelination. If the latter, it would be so delicate to diagnose as demyelination. Especially in such situations, biopsy is often necessary in addition to neuroimaging for distinction TDL with tumorous or infectious diseases. In this article, we will review about concept, epidemiology, diagnosis, and treatment of TDL.
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