Mimicking

模仿
  • 文章类型: Journal Article
    现代神经影像学方法并不能完全排除颅内动脉瘤的误诊,这可能导致与并发症风险相关的不必要的手术。然而,错误诊断的动脉瘤的手术干预非常罕见。这项研究的目的是证明两个假阳性动脉瘤的临床病例,并对致力于假阳性动脉瘤的发生率和病因的文献进行系统回顾,确定与假阳性动脉瘤相关的危险因素。在两个数据库(PubMed和WebofScience)中使用关键字“模仿颅内动脉瘤”进行文献检索,“表现为颅内动脉瘤”,“颅内动脉瘤假阳性”,并进行了“神经外科手术”。在两个数据库中的初始搜索中共发现了243篇论文。最终分析包括16篇论文(包括20例患者)。有10个女人和10个男人。假阳性动脉瘤的最常见位置是大脑中动脉(MCA)的分叉。在后循环中,在基底动脉上发现了假阳性动脉瘤,或者在椎-基底交界处.颅内动脉瘤假性诊断的主要原因包括动脉闭塞伴血管残端形成,漏斗加宽,开窗术,动脉夹层,造影剂外渗,和静脉静脉曲张.总之,总结我们的分析结果,我们可以说,假阳性动脉瘤的手术干预在血管神经外科中是一个被低估的问题。尽管发表的临床观察非常罕见,对假阳性动脉瘤进行错误手术干预的实际频率未知.
    Modern neuroimaging methods do not completely rule out false diagnoses of intracranial aneurysms which can lead to an unwarranted operation associated with risks of complications. However, surgical interventions for falsely diagnosed aneurysms are quite rare. The purpose of this study is to demonstrate two clinical cases of false-positive aneurysms and a systematic review of the literature dedicated to the incidence and etiology of false-positive aneurysms, identifying risk factors associated with false-positive aneurysms. A literature search in two databases (PubMed and Web of Science) using keywords \"mimicking an intracranial aneurysm\", \"presenting as an intracranial aneurysm\", \"false positive intracranial aneurysms\", and \"neurosurgery\" was conducted. A total of 243 papers were found in the initial search in two databases. Sixteen papers (including 20 patients) were included in the final analysis. There were 10 women and 10 men. The most common location of false-positive aneurysms was the bifurcation of the middle cerebral artery (MCA). In the posterior circulation, false-positive aneurysms were identified either on the basilar artery, or at the vertebro-basilar junction. The main causes of false intracranial aneurysm diagnosis included artery occlusion with vascular stump formation, infundibular widening, fenestration, arterial dissection, contrast extravasation, and venous varix. In conclusion, summarizing the results of our analysis, we can say that surgical interventions for false-positive aneurysms are an underestimated problem in vascular neurosurgery. Despite extremely rare published clinical observations, the actual frequency of erroneous surgical interventions for false-positive aneurysms is unknown.
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  • 文章类型: Case Reports
    血吸虫病,一种寄生虫病,是由血吸虫属的血吸虫引起的。神经血吸虫病是最严重的血吸虫病,当宿主的大脑和脊髓对卵子的沉积作出反应时,导致神经症状.神经血吸虫病引起各种体征和症状,比如脊髓病,神经根病,颅内压升高.
    一名来自埃塞俄比亚的12岁儿童,下肢进行性无力,持续2个月。除了弱点,患者下肢也有刺痛感和麻木。此外,他有膀胱和肠失禁。脊柱MRI显示有粘液乳头状室管膜瘤的征象,但组织病理学结果显示血吸虫病。术后,患者的下肢无力(手指闪烁)略有改善。然而,他的节制能力没有改善。
    曼氏血吸虫感染最常见的神经系统表现是脊髓病,其中包括亚急性脊髓病和急性横贯性脊髓炎。马尾和延髓圆锥是最常受影响的区域。
    当脊柱血吸虫病表现为模仿脊柱肿瘤时,它提出了一个复杂的临床挑战,需要一个全面的跨学科方法,以确保准确的诊断和有效的治疗。这是当务之急的保健医生,以提高他们的知识和这种罕见的寄生虫感染的认识,特别是在流行的地区。
    UNASSIGNED: Schistosomiasis, a parasitic disease, is caused by blood flukes from the schistosoma genus. Neuroschistosomiasis is the most severe form of schistosomiasis, which occurs when the host\'s brain and spinal cord react to the deposition of eggs, leading to neurological symptoms. Neuroschistosomiasis causes various signs and symptoms, such as myelopathy, radiculopathy, and elevated intracranial pressure.
    UNASSIGNED: A 12-year-old child from Ethiopia who presented with progressive weakness in his lower extremities that has been ongoing for 2 months. Alongside the weakness, the patient also experienced tingling sensations and numbness in his lower extremities. Additionally, he had bladder and bowel incontinence. Spinal MRI showed signs suggestive of myxopapillary ependymoma, but the histopathology result showed schistosomiasis. Postoperatively, the patient had a slight improvement in terms of lower extremity weakness (flickering of the digits). However, there was no improvement in his continence ability.
    UNASSIGNED: The most common neurological manifestation of Schistosoma mansoni infection is myelopathy, which includes subacute myeloradiculopathy and acute transverse myelitis. The cauda equina and conus medullaris are the areas most frequently affected.
    UNASSIGNED: When spinal schistosomiasis presents itself as a mimicking spinal tumour, it poses a complex clinical challenge that necessitates a comprehensive interdisciplinary approach to ensure accurate diagnosis and effective treatment. It is imperative for healthcare practitioners to enhance their knowledge and awareness of this uncommon parasitic infection, particularly in regions where it is prevalent.
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  • 文章类型: Case Reports
    毛细血管瘤,通常在皮肤和粘膜组织中发现,很少在脊髓内遇到,提出了重大的诊断挑战。我们报告了一名66岁女性患者的脊髓圆锥硬膜内髓外毛细血管瘤的罕见病例。由于存在囊性形成和壁结节增强,因此根据MRI发现,我们的初步诊断倾向于囊性血管母细胞瘤。然而,手术探查和随后的病理检查显示病变为毛细血管血管瘤。就作者所知,该病例可能是首次有文献记载的脊髓毛细血管瘤,其模拟囊性血管母细胞瘤。
    Capillary hemangiomas, usually found in skin and mucosal tissues, are rarely encountered within the spinal cord, presenting a significant diagnostic challenge. We report a rare case of intradural extramedullary capillary hemangioma at the conus medullaris in a 66-year-old female patient. Our initial diagnosis leaned towards a cystic hemangioblastoma based on MRI findings due to the presence of cystic formation with an enhanced mural nodule. However, surgical exploration and subsequent pathological examination revealed the lesion as a capillary hemangioma. To the authors\' knowledge, this case may represent the first documented instance of a spinal capillary hemangioma that mimics a cystic hemangioblastoma.
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  • 文章类型: Case Reports
    尽管气道异物吸入(FBA)在任何年龄段都很常见,肺部未识别和保留的异物可能导致严重的并发症,如肺脓肿或支气管扩张。在极少数情况下,FBA可能与许多其他疾病(例如哮喘,肿瘤,肺嗜酸性粒细胞增多)。这里,我们报道了一个罕见的9岁男孩错过FBA的病例,其胸部CT扫描提示左下叶有空洞性病变,模仿先天性肺气道畸形(CPAM)。然而,令人惊讶的是,柔性支气管镜检查发现花生滞留在左下叶的外侧基底段,随后由镊子取回,避免了不必要的手术肺叶切除术。因此,FBA可以模仿其他疾病(例如CPAM),并且可能需要高度怀疑和额外的诊断技术(例如柔性支气管镜)来区分它们。此外,在儿童呼吸道疾病的鉴别诊断中,即使没有误吸史,也应考虑FBA。
    Although airway foreign body aspiration (FBA) is a common occurrence in any age group, unrecognized and retained foreign bodies in lungs may result in severe complications, such as lung abscess or bronchiectasis. In rare cases, FBA may present with similar clinical features as many other diseases (e.g. asthma, tumor, pulmonary eosinophilia). Here, we report a rare case of missed FBA in a nine-year-old boy, whose chest CT scan was suggestive of a cavitary lesion in the left lower lobe mimicking congenital pulmonary airway malformation (CPAM). However, surprisingly, flexible bronchoscopy revealed a peanut lodged in the lateral basal segment of left lower lobe, which was subsequently retrieved by a forceps and avoided unnecessary surgical lobectomy. Therefore, FBA can mimic other disorders (e.g. CPAM), and a high index of suspicion and additional diagnostic techniques (e.g. flexible bronchoscopy) may be required to distinguish them. Additionally, FBA should be considered in the differential diagnosis of respiratory disorders in children even lack of aspiration history.
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  • 文章类型: Case Reports
    肺错构瘤是最常见的切除的肺良性肿瘤。间充质囊性亚型是由多个囊肿和结节组成的罕见且经常双侧发生的变体。在这里,我们介绍了一名无症状的70岁女性,其右肺门区域有一个大的,主要是囊性的生长。胸部计算机断层扫描和氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描成像将其起源追溯到右中叶。总体特征提示原发性肺癌或其他囊性肺病。因为经支气管肺活检未能建立组织学诊断,右中叶切除术采用胸腔镜手术.大体手术标本有一个单个且相当大(8.0×4.0cm)的囊性病变,其中包含多个黄白色结节。最终诊断为间叶囊性和软骨样错构瘤。这个特殊的案例值得注意,考虑到最初与原发性肺癌的临床相似。
    Pulmonary hamartoma is the most commonly resected benign neoplasm of lung. The mesenchymal cystic subtype is a rare and often bilaterally occurring variant composed of multiple cysts and nodules. Herein, we present an asymptomatic 70-year-old woman with a large and mostly cystic growth of right hilar region. Computed tomography of the chest and fluorodeoxyglucose positron emission tomography/computed tomography imaging traced its origins to right middle lobe. Overall features suggested primary lung cancer or perhaps other cystic lung disease.Because transbronchial lung biopsy failed to establish a histologic diagnosis, right middle lobectomy was undertaken by video-assisted thoracoscopic surgery. The gross surgical specimen harbored a single and sizeable (8.0 × 4.0 cm) cystic lesion containing multiple yellow-white nodules. A diagnosis of mesenchymal cystic and chondroid hamartoma was ultimately rendered. This particular case is noteworthy, given the initial clinical resemblance to primary lung cancer.
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  • 文章类型: Case Reports
    一名61岁女性在体检中出现右心房肿块。左心超声造影显示右心房有一块32*23mm大小的肿块,附着在房间隔上;有一定程度的活动和变形。MRI显示右心房邻近房间隔约35*22毫米的肿块,被诊断为右心房粘液瘤。术中TEE显示肿块位于靠近下腔静脉的房间隔中,自发回声与肿块内的高回声图像形成对比。在体外循环下切除病灶。病理检查显示充盈缺损为房间隔血源性囊肿伴钙化。
    A 61-year-old female presented with right atrial mass during physical examination. Contrast-enhanced left heart echocardiography revealed a mass with the size of 32*23 mm in the right atrium, attached to the atrial septum; there was a certain degree of activity and deformation. MRI showed a mass of about 35*22 mm in the right atrium adjacent to the atrial septum, which was diagnosed with right atrial myxoma. Intraoperative TEE showed that the mass was located in the atrial septum close to the inferior vena cava and spontaneous echo contrast with hyperechoic images within the mass. The lesion was resected under cardiopulmonary bypass. Pathological examination revealed that the filling defect was an atrial septal hematogenous cyst with calcification.
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  • 文章类型: Case Reports
    结节病是一种多器官的全身性疾病,有多种临床表现。患者会出现神经系统并发症。神经结节病可能危及生命;因此,早期识别和治疗是关键。这里,我们介绍了一例55岁的非裔美国男性,他主诉头晕和左侧无力;经过精心的影像学检查和膀胱肿块活检,他最终被诊断为神经结节病.神经结节病仍然是一个诊断难题,因为它可以在临床和影像学上模拟多种疾病,包括多发性硬化症。中枢神经系统淋巴瘤,多发性骨髓瘤,和进行性多灶性白质脑病。
    Sarcoidosis is a multi-organ systemic disease that presents with several clinical manifestations, and patients can develop neurologic complications. Neurosarcoidosis may be life-threatening; therefore, early recognition and treatment are key. Here, we present a case of a 55-year-old African American male who presented with a complaint of dizziness and left-sided weakness; he ultimately received a diagnosis of neurosarcoidosis after elaborate radiographic investigations and bladder mass biopsy. Neurosarcoidosis remains a diagnostic dilemma as it can clinically and radiographically mimic multiple conditions including multiple sclerosis, central nervous system lymphoma, multiple myeloma, and progressive multifocal leukoencephalopathy.
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  • 文章类型: Case Reports
    与COVID-19相关的儿童多系统炎症综合征的主要器官系统是胃肠道系统,这在几乎90%的患者中观察到。胃肠道症状可以模拟急性阑尾炎。曾有少例与SARS-CoV-2相关的多系统炎症综合征患儿误诊为阑尾炎,以及COVID-19大流行期间与急性阑尾炎相关的多系统炎症综合征的一些伴随病例。这里,我们介绍了一个11岁女孩的病例,她出现在我们的重症监护病房,有2天的发烧史,全身腹痛,和呕吐。临床发现导致临床怀疑急性阑尾炎和随后的手术。虽然术后,她病危了,她在与COVID-19相关的儿童中被诊断出患有多系统炎症综合征。在诊断儿童急性阑尾炎时,医疗保健专业人员,尤其是儿科医生和外科医生,必须注意与SARS-CoV-2感染相关的多系统炎症综合征。
    The predominant organic system involved in multisystem inflammatory syndrome in children associated with COVID-19 is the gastrointestinal system, which is observed in almost 90% of patients. Gastrointestinal symptoms can mimic acute appendicitis. There have been a few cases of misdiagnosed multisystem inflammatory syndrome in children associated with SARS-CoV-2 as appendicitis, and a few concomitant cases of a multisystem inflammatory syndrome associated with acute appendicitis during the COVID-19 pandemic. Here, we present the case of an 11-year-old girl who presented to our Intensive Care Unit with a 2-day history of fever, generalized abdominal pain, and vomiting. The clinical findings resulted in a clinical suspicion of acute appendicitis and subsequent surgery. While postoperatively, she became critically ill, and she was diagnosed with the multisystem inflammatory syndrome in children associated with COVID-19. When diagnosing children with acute appendicitis, healthcare professionals, especially pediatricians and surgeons, must pay attention to the multisystem inflammatory syndrome linked to the SARS-CoV-2 infection.
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  • 文章类型: Journal Article
    未经证实:少数颅内病变仅表现为位置性眩晕,极易误诊为良性阵发性位置性眩晕(BPPV),临床医生应重视本病。
    UNASSIGNED:分析6例仅表现为位置性眩晕的颅内肿瘤患者的临床特征,以避免误诊。
    UNASSIGNED:对2015年5月至2019年5月期间在我们诊所治疗的6例仅表现为位置性眩晕的颅内肿瘤患者进行了回顾。和临床症状,眼球震颤的特征,成像演示,并对患者的最终诊断进行评估。
    UNASSIGNED:所有患者均表现为位置性眩晕和位置性眼震,包括一个在位置测试中眼球震颤下降的病例,两例左跳眼球震颤,在滚动测试中出现了一例向外性眼球震颤,一例右侧眼球震颤,还有一例左打和眼球震颤。脑部MRI显示肿瘤区域位于小脑的疣中,第四脑室,侧脑室,和小脑半球。
    UNASSIGNED: A few intracranial lesions may present only with positional vertigo which are very easy to misdiagnose as benign paroxysmal positional vertigo (BPPV); the clinicians should pay more attention to this disease.
    UNASSIGNED: To analyze the clinical characteristics of 6 patients with intracranial tumors who only presented with positional vertigo to avoid misdiagnosing the disease.
    UNASSIGNED: Six patients with intracranial tumors who only presented with positional vertigo treated in our clinic between May 2015 to May 2019 were reviewed, and the clinical symptoms, features of nystagmus, imaging presentation, and final diagnosis of the patients were evaluated.
    UNASSIGNED: All patients presented with positional vertigo and positional nystagmus induced by the changes in head position or posture, including one case with downbeating nystagmus in a positional test, two cases with left-beating nystagmus, one case with apogeotropic nystagmus in a roll test, one case with right-beating nystagmus, and one case with left-beating and upbeating nystagmus. Brain MRI showed the regions of the tumors were in the vermis of the cerebellum, the fourth ventricle, the lateral ventricle, and the cerebellar hemisphere.
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  • 文章类型: Case Reports
    滑膜骨软骨瘤病是儿童和青少年中极为罕见的良性疾病,以关节疼痛为表现。它通常是单关节,膝关节是最常见的受影响的关节。在这篇文章中,我们描述了一个女性青少年患有衰弱性慢性右膝疼痛的情况,最初模仿青少年特发性关节炎,随后被诊断为原发性滑膜骨软骨瘤病。我们对滑膜骨软骨瘤病的临床表现进行了综述,射线照相特征,组织病理学发现,和治疗,总结了最初有肌肉骨骼表现的儿童患者,这些患者最终被诊断为滑膜骨软骨瘤病。尽管滑膜骨软骨瘤病在儿童和青少年中很少见,这种情况应包括在关节痛的鉴别诊断中,并且可能与幼年特发性关节炎相似。适当的诊断射线照相术,包括平片和磁共振成像,是准确诊断这种情况所必需的。我们还强调了多学科团队方法管理滑膜骨软骨瘤病患者的重要性。
    Synovial osteochondromatosis is an extremely rare benign condition in children and adolescents that have joint pain as a presenting manifestation. It is usually monoarticular with the knee as the most common affected joint. In this article, we describe the case of a female adolescent suffering from debilitating chronic right knee pain initially mimicking juvenile idiopathic arthritis, who was subsequently diagnosed with primary synovial osteochondromatosis. We present a review of synovial osteochondromatosis focusing on the clinical manifestations, radiographic features, histopathologic findings, and treatment, with a summarized review of pediatric patients with initial musculoskeletal presentations who were ultimately diagnosed as synovial osteochondromatosis. Although synovial osteochondromatosis is rare in children and adolescents, this condition should be included in the differential diagnosis of joint pain and may mimic juvenile idiopathic arthritis. Appropriate diagnostic radiography, including both plain radiography and magnetic resonance imaging, is necessary to accurately diagnose this condition. We also emphasize the importance of a multidisciplinary team approach to managing patients with synovial osteochondromatosis.
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