原发性椎管内淋巴瘤的诊治——附6例临床分析  

Diagnosis and Treatment of Primary Intraspinal Lymphomas:Report of 6 Cases

作　　者：刘磊[1] 王贵怀[1] 杨俊[1] 刘藏[1] 

机构地区：[1]首都医科大学附属北京天坛医院神经外科,北京100050

出　　处：《中国神经肿瘤杂志》2007年第1期38-41,共4页Chinese Journal of Neuro-Oncology

摘　　要：背景与目的:原发性椎管内淋巴瘤十分罕见,本研究旨在总结原发椎管内淋巴瘤的临床特点,影像学特征及治疗手段,以提高对此病的认识。方法:对北京天坛院神经外科三病房2000年1月至2006年12月间收治的6例经病理证实为椎管内恶性淋巴瘤的患者进行回顾性分析,并文献复习。结果:6例患者中,男性4例,女性2例,中位年龄38.5岁。4例患者首发症状为疼痛,平均病程10.9个月。所有患者术前均行MRI检查,肿瘤位于颈段4例,胸段1例,骶段1例。本组患者均采取显微手术治疗,术中辅以电生理监测,肉眼全切1例,近全切除4例,大部分切除1例,无手术死亡。术后4例症状缓解,出院后全部患者均行放射治疗,效果满意。结论:原发性椎管内淋巴瘤是椎管内的罕见肿瘤,缺乏特异性的影像学表现。椎板切除减压,肿瘤切除,术后辅以局部放疗和全身化疗是其主要治疗手段,预后较好。BACKGROUND ＆ OBJECTIVE： Primary intraspinal lymphomas are rare, this study is to investigate clinical manifestations, imaging and management of primary intraspinal lymphomas. METHODS： Six cases of pathologically confirmed primary intraspinal lymphoma, treated in the 3rd ward of department of Neurosurgery, Beijing Tiantan Hospital, from January of 2000 to December of 2006 were retrospectively analyzed. RESULTS： Among the 6 patients,there were 4 men and 2 women with an average age of 38.2 years old. Pain was the initial symptom in 4 patients. The average course of disease was 10.9 months. All the patients were examined by preoperative MRI scan. There were 4 tumors located in cervical segment, 1 tumor in thoracic segment and 1 located in sacral segment. Intraoperative electrophysiologic monitoring was adopted. Total resection under naked eye was achieved in 1 case, subtotal removal in 4 cases, and partial removal in 1 case. There was no surgical death. Symptomatic was attained in 4 patients, radiotherapy was performed on all patients after surgery. CONCLUSIONS： Primary intraspinal lymphomas are rare intraspinal tumors without specific imaging features. Laminectomy, tumor resection, post-operative radiotherapy and chemotherapy are main treatment modalities. The prognosis is relatively good.

关 键 词：原发性椎管内淋巴瘤 硬膜外 手术 放疗 化疗 

分 类 号：R739.41[医药卫生—肿瘤]