CT上髄腔内播種と診断される悪性脳腫瘍の予後と病態

Clinico-pathological Studies of CSF Dissemination of Glioblastoma and Medulloblastoma

I．はじめに

　悪性腫腫瘍のなかでもmedulloblastomaやgermi—nomaは髄腔内播種をきたしやすい腫瘍とされている．播種後の予後は一般に不良で，その診断および治療は現在でも重要な課題となっている^{7, 10）}．これに対し，ma—lignant gliomaもCT上，脳室壁あるいは脳底槽にそって増強効果を伴う線状陰影が出現し，腫瘍の髄腔内播種が疑われると，その後の予後は極めて不良なことは日常よく経験するところである．今回われわれはこれら，CT上髄腔内播種と診断されたmalignant gliomaをmedulloblastomaの髄腔内播種と比較検討したので報告する．

Clinico-pathological findings of CSF dissemination which was diagnosed on CT scan, were studied on 13 cases of glioblastoma and 9 cases of medullo-blastoma.

The type of CSF dissemination and the prognosis of patients were both different between glioblastoma and medulloblastoma. In the former, the dis-semination was predominantly in ventricular walls and in the latter, in basal cisterns. The mean survival time after the diagnosis of dissemination is 6 months of glioblastoma as compared with 13 months of medulloblastoma.