原发性中枢神经系统淋巴瘤回顾性分析(附九例报告)  

Retrospective analysis of treating primary central nervous system lymphoma: report of nine cases

作　　者：王伟民[1] 符丽[2] 吴国庆[1] 孙淼[1] 丰育功[1] 

机构地区：[1]山东省青岛市市立医院神经外科,266011 [2]山东省青岛市市立医院骨科,266011

出　　处：《中华神经医学杂志》2005年第4期394-396,共3页Chinese Journal of Neuromedicine

摘　　要：目的探讨原发性中枢神经系统淋巴瘤(PCNSL]的临床表现、治疗及预后。方法对9例经病理证实的PCNSL患者临床资料进行回顾性分析。本组病例均行手术治疗,术后部分病人辅以放化疗治疗。结果本组存活时间6-38月,中位生存时间27月,死因为肿瘤复发、肺部感染、上消化道出血。结论PCNSL恶性程度较高,术前诊断困难,预后不良。手术活检证实诊断后的高剂量氨甲喋呤结合全脑放疗的综合治疗方案可以明显延长存活时间,但最佳的治疗方案及治疗剂量仍需进一步研究确定。Objective To explore the clinical manifestations, therapy and prognosis of primary central nervous system lymphoma (PCNSL). Methods 9 cases of PCNSL proved by pathology were reviewed with regard of clinical information. Results All the 9 cases had single lesion, 7 lesions locating in the deep white matter including 1 case complicated by apoplexia and 2 lesions in lateral ventricle. The lesions with the shape of a spheroid or butterfly showed minimal or moderate edema around the lymphoma in white matter. Plain CT images exhibited homogeneous iso- or hyper-dense enhancement after contrast administration, with no calcification and few hemorrhage. T1 and T2 MR images showed iso- or hypo-intense, and contrast-enhanced scan could intensify the lymphoma evenly and obviously. Conclusion PCNSL is an aggressive malignancy with a poor prognosis and difficult to diagnose before operation. The outcome of patients with PCNSL is rapidly improved with high-dose methotrexate (MTX) followed by whole-brain radiotherapy. But the best treatment plan and dose demands further research.

关 键 词：原发性中枢神经系统淋巴瘤 回顾性分析 PCNSL 上消化道出血 综合治疗方案 存活时间 临床表现 临床资料 病理证实 手术治疗 化疗治疗 生存时间 肿瘤复发 肺部感染 恶性程度 诊断困难 全脑放疗 氨甲喋呤 手术活检 预后不良 

分 类 号：R739.4[医药卫生—肿瘤] R651.15[医药卫生—临床医学]