Clinicopathological study of central nervous system diffuse and multifocal lesions in cerebral white matter

Abstract

Objective To investigate the clinicopathological features of central nervous system diffuse and multifocal lesions in the cerebral white matter. Methods The clinical and radiological data of 27 cases of diffuse and multifocal lesions in the cerebral white matter were collected from January 2015 to December 2020. The pathological features of these cases were retrospectively analyzed. Results All cases ranged from 10 to 73 years old, female 12 cases, male 15 cases. Clinical manifestations included dyskinesia and paresthesia (17 cases), headache and dizziness (10 cases), cognitive decline and language dysfunction (3 cases each), sleep disorder, visual impairment and epilepsy seizure (2 cases each). They showed diffuse and multifocal lesions in the cerebral white matter involving three or more lobes. Twenty⁃four cases performed stereotactic puncture, and 3 others accepted craniotomy. Pathological findings included 11 tumoral lesions, such as diffuse glioma 8 cases, lymphomatosis cerebri 2 cases, intravascular large B cell lymphoma one case; as well as 16 cases non⁃tumor lesions, such as idiopathic inflammatory demyelinating diseases 10 cases, primary angiitis of central nervous system 3 cases, progressive multifocal leukoencephalopathy one case, leukoencephalopathy with cerebral calcifications and cysts one case, and adult⁃onset leukoencephalopathy with axonal spheroids and pigmented glia one case. Conclusions Diffuse and multifocal lesions of the cerebral white matter includes tumor and non⁃tumoral diseases with no specific clinical manifestations. Stereotactic puncture is needed to reach a correct clinicopathological diagnosis, and ensure the precision treatment.

doi：10.3969/j.issn.1672⁃6731.2021.04.007