椎管内血液系统肿瘤的诊治分析(附7例报道)  

Diagnosis and treatment of intraspinal blood system tumor (report of 7 cases)

作　　者：张嘉[1] 王振宇[1] 林国中[1] 于涛[1] 

机构地区：[1]北京大学第三医院神经外科,北京100191

出　　处：《中国临床神经外科杂志》2016年第1期13-16,共4页Chinese Journal of Clinical Neurosurgery

摘　　要：目的探讨椎管内血液系统肿瘤的临床特点、影像学特征及治疗方法。方法回顾性分析2000年1月至2014年12月收治的7例经病理证实的椎管内血液系统肿瘤患者的临床资料,均采取显微手术治疗,术中辅以电生理监测。结果 MRI检查示,肿瘤位于椎管颈段1例、颈胸段1例、胸段3例、腰骶段2例。肉眼全切除2例,次全切除4例,大部分切除1例;术后病理结果为非霍杰金淋巴瘤5例,白血病2例。5例淋巴瘤患者术后症状均有缓解;2例白血病患者起病急,术前即已瘫痪伴大小便失禁,术后症状无明显变化。结论椎管内血液系统肿瘤少见,尤其白血病十分罕见;其影像学表现缺乏特异性,当出现脊髓压迫表现时,建议早期行切除椎板减压术+肿瘤切除术,以挽救神经功能,术后根据病理辅以局部放疗和全身化疗;其综合预后取决于肿瘤的恶性程度及全身治疗情况。Objective To summarize the clinical and imaging characteristics and therapeutic methods of the intraspinal blood system tumor. Methods The clinical data of 7 patients with intraspinal blood system tumor undergoing microsurgery under the electrophysiological monitoring in our hospital from January, 2000 to December, 2014 were analyzed retrospectively. Results The preoperative MRI showed the tumor was located in the cervical segment of the spinal cord in 1 patient, the cervieothoracic segment in 1, thoracic segment in 3, lumbosacral segment in 2. Of 7 patients, 2 received total resection of the tumors, 4 subtotal and 1 partial. Pathological examination showed that of 7 patients, 5 had non-Hodgkin＇s lymphomas and 2 leukemia. The postoperative symptoms were relieved in 5 patients with non-Hodgkin lymphomas and unchanged in 2 patients with leukemia. No patients died from the surgery. All the patients received systemic chemotherapy and 2 local radiotherapy after discharge from the hospital. Conclusions The intraspinal blood system tumor, especially leukemia, is a rare intraspinal tumor. The imaging manifestations of the intraspinal blood system tumor lack specificity. The microsurgery including decompression laminetomy and resection of the tumors should be recommended in the patients with symptoms caused by the compression of the spinal cord. The local radiotherapy and systemic chemotherapy should be performed according to postoperative pathological outcomes in the patients with intraspinal blood system tumor.

关 键 词：椎管内肿瘤 淋巴瘤 白血病 诊断 治疗 

分 类 号：R739.42[医药卫生—肿瘤] R651.11[医药卫生—临床医学]