| 汤立建.1型神经纤维瘤病合并胸腔内脊膜膨出误诊为包裹性胸腔积液1例[J].安徽医药,待发表. |
| 1型神经纤维瘤病合并胸腔内脊膜膨出误诊为包裹性胸腔积液1例 |
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| 投稿时间：2026-07-01 录用日期：2026-08-06 |
| DOI： |
| 中文关键词: 1型神经纤维瘤病 胸腔内脊膜膨出 包裹性胸腔积液 误诊 |
| 英文关键词: |
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| 中文摘要: |
| 目的 本文通过分析1例1型神经纤维瘤病合并胸腔内脊膜膨出误诊为包裹性胸腔积液的临床资料，总结该病临床、影像学特征及误诊防范要点，提升临床医师对本病的识别能力，减少误诊误治。方法 回顾性分析胜利油田中心医院1例初诊误诊为右侧包裹性胸腔积液的1型神经纤维瘤病合并胸腔内脊膜膨出患者的临床资料、影像学特征及诊疗经过，总结误诊原因并提炼诊疗经验。结果 本例患者胸部计算机断层扫描（Computed Tomography，CT）提示右侧包裹性胸腔积液，行超声引导下胸腔穿刺引流，抽取无色透明液体，积液生化、常规指标与普通胸腔积液特征不符，且穿刺后出现符合颅内低压综合征的临床表现。进一步完善脊柱磁共振成像（Magnetic Resonance Imaging，MRI），最终确诊为1型神经纤维瘤病合并胸腔内脊膜膨出。结论 1型神经纤维瘤病合并胸腔内脊膜膨出误诊率极高。对于确诊1型神经纤维瘤病、影像学提示包裹性胸腔积液的患者，需高度警惕本病，严禁盲目实施胸腔有创操作，尽早完善脊柱MRI检查明确诊断，从而降低误诊风险、规避严重并发症，保障诊疗安全。 |
| 英文摘要: |
| Objective To analyze the clinical data of one case of type 1 neurofibromatosis complicated by intrathoracic meningocele that was misdiagnosed as encapsulated pleural effusion, summarize the clinical and imaging features of the disease and the key points for preventing misdiagnosis, so as to improve clinicians' ability to recognize this condition and reduce misdiagnosis and inappropriate treatment.Methods The clinical data, imaging features, and diagnostic and treatment process of one patient with type 1 neurofibromatosis complicated by intrathoracic meningocele, initially misdiagnosed as right-sided encapsulated pleural effusion at Shengli Oilfield Central Hospital, were retrospectively analyzed. The causes of misdiagnosis were summarized and diagnostic and therapeutic experience was extracted.Results Chest computed tomography (CT) suggested right-sided encapsulated pleural effusion. Ultrasound-guided thoracentesis was performed, and colorless transparent fluid was aspirated. The biochemical and routine laboratory indices of the effusion were inconsistent with those of ordinary pleural effusion, and the patient developed clinical manifestations consistent with intracranial hypotension syndrome after the puncture. Further spinal magnetic resonance imaging (MRI) was subsequently completed, and the patient was finally diagnosed with type 1 neurofibromatosis complicated by intrathoracic meningocele.Conclusions Type 1 neurofibromatosis complicated by intrathoracic meningocele has an extremely high rate of misdiagnosis. For patients with a confirmed diagnosis of type 1 neurofibromatosis and imaging findings suggestive of encapsulated pleural effusion, a high index of suspicion for this condition is warranted. Blind invasive thoracic procedures should be strictly avoided, and spinal MRI should be performed as early as possible to confirm the diagnosis, thereby reducing the risk of misdiagnosis, preventing severe complications, and ensuring the safety of diagnosis and treatment. |
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