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Neurological Surgery No Shinkei Geka Volume 29, Issue 6 （June 2001）

Neurological Surgery 脳神経外科 29巻6号（2001年6月発行）

Japanese English

症例

脳腫瘍と鑑別が困難であったNeuro-Behcet病の1生検例 Neuro-Behcet Disease Mimicking a Thalamic Tumor 吉村淳一 ¹ , 外山孚 ¹ , 関原芳夫 ¹ , 玉谷真一 ¹ , 永井博子 ² , 藤田信也 ² , 江村巌 ³ , 山田光則 ⁴ Junichi YOSHIMURA ¹ , Makoto TOYAMA ¹ , Yoshio SEKIHARA ¹ , Shinichi TAMATANI ¹ , Hiroko NAGAI ² , Shinya FUJITA ² , Iwao EMURA ³ , Mitsunori YAMADA ⁴ ¹長岡赤十字病院脳神経外科 ²長岡赤十字病院神経内科 ³長岡赤十字病院病理 ⁴新潟大学脳研究所病理学分野 ¹Department of Neurosurgery, Nagaoka Red Cross Hospital ²Department of Neurology, Nagaoka Red Cross Hospital ³Department of Pathology, Nagaoka Red Cross Hospital ⁴Department of Pathology, Brain Research Institute, Niigata University キーワード： Behcet disease , neuro-Behcet disease , magnetic resonance imaging , cerebral tumor , stereotactic biopsy Keyword: Behcet disease , neuro-Behcet disease , magnetic resonance imaging , cerebral tumor , stereotactic biopsy pp.527-531

発行日 2001年6月10日 Published Date 2001/6/10

DOI https://doi.org/10.11477/mf.1436902052

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Abstract 文献概要
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I．はじめに

　Behcet病は再発性口腔内アフタ性潰瘍，外陰部潰瘍，ブドウ膜炎を3主徴とする原因不明の炎症性疾患であり，中枢神経障害を合併したneuro-Behcet病はBehcet病の約10％に認められる^{6,10，11,14,18,22）}．Neuro-Behcet病は脳幹部や基底核に好発し，ときに多発性硬化症や脳腫瘍など他の疾患との鑑別が問題となる．

　今回われわれは口腔内アフタ，外陰部潰瘍を繰り返し，若年の痴呆，右片麻痺にて発症した不全型neuro-Behcet病で術前脳腫瘍との鑑別が困難であった1生検例を経験したので報告する．

A case of neuro-Behcet disease presenting as a thalamo-lenticular expanding lesion is reported. A 41-year-old female was admitted with mental deterioration and right hemiparesis. She had been suffering fromrecurrent oral and genital ulcers and erythema nodosum for several years before admission. Neurologicalexamination on admission revealed poor mental activity, dysarthria and right hemiparesis. Lumbar punc-ture showed CSF pleocytosis. CT and MRI revealed a thalamo-lenticular expanding lesion. CT showed ahomogeneous hypodense lesion of the left lenticulothalamic region, which was enhanced in the centralpart, exerting a mild mass effect. MRI also revealed the lesion better. The T2 weighted images showed ahigh intensity signal in the left thalamo-lenticular region and the left peduncle. The Ti weighted imagesshowed a low signal in the corresponding areas with a central enhancement with Gd-DTPA. EEG, SPECTand angiography indicated normal findings. Histologic study of the brain biopsy tissue ruled out a tumorbut did not show any specific diagnosis. The patient improved with steroid therapy. In conclusion, the clinical and radiological presentation of neuro-Behcet disease can mimic a cerebraltumor. In such cases, stereotactic biopsy is useful to exclude suspicion of a cerebral tumor.