原发性中枢神经系统淋巴瘤的诊治分析  

Clinical analysis of diagnosis and treatment of primary central nervous system lymphoma (report of 12 cases)

作　　者：刘仁忠[1] 王峻[1] 连海伟[1] 杨振兴[1] 王雷[1] 刘佳[1] 秦兴平[1] 余信远[1] 

机构地区：[1]武汉大学人民医院神经外科,武汉430060

出　　处：《中国临床神经外科杂志》2014年第2期68-70,73,共4页Chinese Journal of Clinical Neurosurgery

摘　　要：目的探讨原发性中枢神经系统淋巴瘤（PCNSL）的诊断与治疗方法。方法2009年1月至2012年12月收治12例PCNSL患者，手术＋放疗＋化疗6例，手术＋放疗1例，活检＋放疗＋化疗4例，活检＋放疗1例。结果本组仅2例术前诊断为PCNSL。病理学检查示弥漫性大B细胞型非霍奇金淋巴瘤10例，小细胞T细胞淋巴瘤2例。10例患者出院后随访10个月至5年，手术＋放疗＋化疗5例，生存2～40个月，平均12．4个月；活检＋放疗＋化疗4例，平均生存11．9个月；活检＋放疗1例生存3个月。结论PCNSLIN床表现缺乏特异性，确诊依赖病理学检查；化疗结合放疗是主要治疗手段；部分病例可考虑个体化手术治疗。Objective To explore the diagnosis and treatment of primary central nervous system lymphoma （PCNSL）. Methods The clinical data 12 patients with PCNSL, of whom, 7 underwent resection of the tumors and 5 stereotactic biopsy from January 2009 to December 2012, were analyzed retrospectively. Results The pathological outcomes showed diffuse large B cell lymphoma in 10 patients and small lymphocytic T cell lymphoma in 2. Only 2 patients were diagnosed as PCNSL based on clinical manifestations and imaging characteristics before operation. Ten patients were followed up from 10 months to 5 years. Five patients who received surgery, chemotherapy and radiotherapy survived for 12.4 months （range, 2~40 months）. Four patients who received biopsy, chemotherapy and radiotherapy survived for 11.9 months. One patient who received biopsy and radiotherapy survived for 3 months. Conclusions The clinical manifestations of PCNSL lack specificity. The definite diagnosis of PCNSL depends on the pathological examination. Chemotherapy combined with radiotherapy is the main treatment of PCNSL. Iindividualized surgical treatment is necessary for certain patients with PCNSL.

关 键 词：原发性中枢神经系统淋巴瘤 诊断 治疗 

分 类 号：R739.41[医药卫生—肿瘤] R651.11[医药卫生—临床医学]