CAJ | 학술논문

目的：探讨常规正常脑脊液在分类计数中检出肿瘤细胞对脑膜癌的诊断价值以及误诊为结核性脑膜炎的原因。方法选择2013年以前医院误诊误治为结核性脑膜炎的脑膜癌患者3例，用计数板计数脑脊液中的白细胞数，再用玻片离心法收集细胞，瑞-姬染色，镜检。结果3例被误诊为结核性脑膜炎的脑膜癌患者脑脊液白细胞计数均小于10个／μL，分类计数均找到肿瘤细胞。其中2例找到肿瘤原发灶。结论检验者对头部症状明显但脑脊液常规白细胞计数小于10个／μL且蛋白明显升高的患者要足够重视，不能免去细胞分类环节，要尽量增加制片张数，以降低漏诊率。
목적：탐토상규정상뇌척액재분류계수중검출종류세포대뇌막암적진단개치이급오진위결핵성뇌막염적원인。방법선택2013년이전의원오진오치위결핵성뇌막염적뇌막암환자3례，용계수판계수뇌척액중적백세포수，재용파편리심법수집세포，서-희염색，경검。결과3례피오진위결핵성뇌막염적뇌막암환자뇌척액백세포계수균소우10개／μL，분류계수균조도종류세포。기중2례조도종류원발조。결론검험자대두부증상명현단뇌척액상규백세포계수소우10개／μL차단백명현승고적환자요족구중시，불능면거세포분류배절，요진량증가제편장수，이강저루진솔。
Objective To investigate the cytological features of the cerebrospinal fluid in the clinical di-agnosis of meningeal carcinomatosis,and analyze the cause of mistaking diagnosis to tuberculous meningitis. Methods Choose 2013 hospitals misdiagnosed as tuberculous meningitis in 3 patients with meningeal carci-noma,counting the total number of leucocytes in cerebrospinal fluid , then cells in cerebrospinal fluid were collected by centrifugation on the glass slide,Wright-Giemsas′stained, finally,calculating the percentage of them by light microscope.Results The number of leucocytes in cerebrospinal fluid of three patients with meningeal carcinomatosis misdiagnosed with tuberculous meningitis was less than 10/μL, however, cancer cells were found in all of the three cases.Conclusion The meningeal carcinomatosis should be highly sus-pected in patients with the symptoms such as severe headache, signs of meningeal irritation,especially with high protein level,but normal cell numbers in cerebrospinal fluid.The classification of cells in cerebrospinal fluid and more slices were effective methods for diagnosis of meningeal carcinomatosis .