每日一题_2023.06.28

A 48-year-old woman is brought to the emergency department after having her first generalized seizure. When questioned, she com- plains of chronic early morning headaches that have increased in severity over the past six months. A neurological examination shows a slight loss of her temporal visual field on the right. Imaging studies reveal the presence of a tumor compressing the optic nerve. Biopsy results are shown in the image. Which of the following is the most likely diagnosis?

一名48岁女性在首次全身性癫痫发作后被送到急诊科。在接受询问时，她抱怨说，在过去6个月里，晨间头痛的严重程度有所加重。神经系统检查显示她的右侧颞侧视野轻度丧失。影像学检查显示存在压迫视神经的肿瘤。活检结果显示在图像中。下列哪一项是最可能的诊断?

(A) Hemangioblastoma 成血管细胞瘤

(B) Meningioma 脑膜瘤

(C) Oligodendroglioma 少突神经胶质瘤

(D) Papillary thyroid carcinoma 甲状腺乳头状癌

(E) Pituitary adenoma 垂体腺瘤

答案解析：

在营养不良钙化的层状区域周围的旋涡状细胞生长模式代表沙砾体。这种病理发现最常见于脑膜瘤、甲状腺乳头状肿瘤和某些卵巢肿瘤。鉴于该患者主诉有癫痫发作、头痛和视野缺损，脑膜瘤是最有可能的答案。

正确答案：B