原发海绵窦区弥漫大B细胞淋巴瘤1例并文献复习  

Primary diffuse large B-cell lymphoma in cavernous sinus:report of 1 case and review of literature

作　　者：黄从刚[1] 罗明[1] 邹亮[2] 王兰兰 柏玉涵[3] 冯燕[4] 吴京雷[1] 王兴弯 罗志华[1] 段发亮[1] Huang Conggang;Luo Ming;Zou Liang;Wang Lanlan;Bai Yuhan;Feng Yan;Wu Jinglei;Wang Xingwan;Luo Zhihua;Duan Faliang(Department of Neurosurgery,Wuhan No.1 Hospital,Wuhan 430022,China;Department of Hematology,Wuhan No.1 Hospital,Wuhan 430022,China;Department of Radiology,Wuhan No.1 Hospital,Wuhan 430022,China;Department of Pathology,Wuhan No.1 Hospital,Wuhan 430022,China)

机构地区：[1]武汉市第一医院神经外科,430022 [2]武汉市第一医院血液内科,430022 [3]武汉市第一医院放射科,430022 [4]武汉市第一医院病理科,430022

出　　处：《白血病．淋巴瘤》2022年第9期551-555,共5页Journal of Leukemia & Lymphoma

摘　　要：目的探讨原发海绵窦区弥漫大B细胞淋巴瘤(DLBCL)患者的临床病理特征、治疗方案及预后。方法回顾性分析武汉市第一医院2020年12月收治的1例原发海绵窦区DLBCL患者的临床资料,并复习相关文献。结果患者为63岁女性,行海绵窦病损切除术,病理诊断为DLBCL。行6个疗程R-CHOP方案化疗,并行腰椎穿刺+鞘内注射化疗药物,再次追加2次利妥昔单抗免疫化疗,脑脊液脱落细胞液基薄层细胞学检查结果未见肿瘤细胞。术后2次复查磁共振成像(MRI)肿瘤未见复发及邻近转移。患者症状明显改善,未遗留神经功能后遗症。结论原发海绵窦区DLBCL临床罕见,早期明确诊断对患者预后至关重要,不同蛋白表达情况可能提示预后。手术活组织检查、保留重要解剖结构及功能前提下肿瘤全切除并规范化疗及联合鞘内注射局部化疗可有效延长患者生存时间,提高生命质量。Objective To investigate the clinicopathological features,treatment programs and prognosis of patients with primary diffuse large B-cell lymphoma(DLBCL)in cavernous sinus.Methods The clinical data of a patient with primary DLBCL in cavernous sinus who were admitted to Wuhan No.1 Hospital in December 2020 were retrospectively analyzed,and the relevant literature was reviewed.Results The patient was a 63-year-old female who underwent resection of the cavernous sinus lesion,and the pathological diagnosis was DLBCL.The patient received 6 courses of R-CHOP regimen chemotherapy,lumbar puncture+intrathecal injection of chemotherapy drugs,and twice additional rituximab immunochemotherapy,and no tumor cells were found in the results of liquid-based thin layer cytology for cerebrospinal fluid exfoliated cells;twice magnetic resonance imaging(MRI)re-examination after the operation showed no recurrence and adjacent metastasis of the tumor.The patient's symptoms were significantly improved without residual neurological sequelae.Conclusions Primary DLBCL in cavernous sinus is rare in clinical practice,early diagnosis is crucial for the prognosis of patients,and different protein expression may indicate the prognosis.Biopsy,complete resection of the tumor under the premise of preserving important anatomical structures and functions,and standardized chemotherapy combined with intrathecal injection local chemotherapy can effectively prolong the survival time of patients and improve the quality of life.

关 键 词：淋巴瘤 大B细胞 弥漫性 海绵窦区 手术切除 化疗 预后 

分 类 号：R739.41[医药卫生—肿瘤]