Aquaporin-4 antibody-positive myelitis initially biopsied for suspected spinal cord tumors: Diagnostic considerations

作者：Sato Douglas Kazutoshi; Misu Tatsuro^*; Rocha Cristiane Franklin; Callegaro Dagoberto; Nakashima Ichiro; Aoki Masashi; Fujihara Kazuo; Lana Peixoto Marco Aurelio

来源：Multiple Sclerosis, 2014, 20(5): 621-626.

DOI：10.1177/1352458513505350

• biopsy
• Neuromyelitis optica
• pathology
• differential diagnosis
• aquaporin-4
• spinal cord tumor

Two patients with longitudinally extensive myelopathy were initially biopsied for suspected spinal cord tumors. Both patients were later diagnosed with neuromyelitis optica spectrum disorders (NMOSD) supported by their AQP4-seropositivity. Pathological review of both biopsies revealed demyelinated lesions with thickened vessel walls and tissue rarefaction. Immunohistochemical staining demonstrated findings compatible with acute NMOSD lesions in one case while the other case exhibited findings consistent with chronic NMOSD lesions. A pre-biopsy differential diagnosis of longitudinally extensive spinal cord tumors should include NMOSD. Specific biopsy features, such as cystic changes with vascular wall thickening and astrocyte injury, should raise suspicion for NMOSD.

• 出版日期2014-4