原发性中枢神经系统组织细胞肉瘤1例并文献复习  

Primary histiocytic sarcoma in the central nervous system: a case report and literature review

作　　者：白吉伟[1] 隋大立[1] 沈宓[2] 林松[1] 李光[3] 

机构地区：[1]首都医科大学附属北京天坛医院神经外科,100050 [2]首都医科大学附属北京天坛医院放射科,100050 [3]首都医科大学附属北京天坛医院病理科,100050

出　　处：《中国微侵袭神经外科杂志》2015年第3期101-104,共4页Chinese Journal of Minimally Invasive Neurosurgery

基　　金：北京市自然科学基金(编号:7144198)

摘　　要：目的探讨原发性中枢神经系统组织细胞肉瘤(CNS HS)的诊断、治疗及预后相关因素。方法回顾性分析1例原发于大脑的CNS HS病人的临床资料,并结合文献进行总结。肿瘤位于额叶,术前影像诊断(包括磁共振波谱分析)考虑胶质瘤,手术全切除。结果术后病理确诊为HS,病人接受调强放疗联合替莫唑胺化疗,随访6个月,肿瘤无复发。结论 HS是少见的淋巴造血系统肿瘤,原发于中枢者罕见,确诊需要病理学支持,治疗方法为手术、放疗和化疗的综合治疗,预后较差。术后同步放化疗可能改善预后。Objective To investigate the diagnostic criteria, clinical management and prognostic factors of primary histiocytic sarcoma （HS） in the central nervous system （CNS）. Methods Clinical data of one patient with primary CNS HS were analyzed retrospectively and the relevant literatures were reviewed. Magnetic resonance imaging including magnetic resonance spectroscopy suggested one mass in the frontal lobe which was considered glioma and the tumor was totally removed. Results The pathological diagnosis revealed histiocytic sarcoma. The patient received intensity-modulated radiation therapy combined with temozolomide chemotherapy. There was no relapse after,the follow-up period of 6 months. Conclusions Primary CNS HS is extremely rare lymphatic and hematopoietic system malignant tumor. The pathological feature and comprehensive immunophenotype panel are the only way to establish the diagnosis. Primary CNS HS should be treated intensively with surgery, chemotherapy and radiation therapy. However, the prognosis is disappointing in most of the patients. Concomitant chemoradiotherapy may improve the prognosis.

关 键 词：组织细胞肉瘤 中枢神经系统 病理学 神经外科手术 放化疗 

分 类 号：R739.4[医药卫生—肿瘤]