两例大脑淋巴瘤病患者的脑脊液改变及影像学特征  

Imaging and cerebrospinal fluid features of two cases with lymphomatosis cerebri

作　　者：陈彬[1] 牛松涛[1] 石玉芝[1] 王新高[1] 董格红 刘焕光[3] 张在强[1] Chen Bin;Niu Songtao;Shi Yuzhi;Wang Xingao;Dong Gehong;Liu Huanguang;Zhang Zaiqiang(Department of Neurology,Beijing Tiantan Hospital,Capital Medical University,China National Clinical Research Center for Neurological Diseases,Beijing 100070,China;Department of Pathology,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China;Department of Neurosurgery,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China)

机构地区：[1]首都医科大学附属北京天坛医院神经病学中心国家神经系统疾病临床医学研究中心,北京100070 [2]首都医科大学附属北京天坛医院病理科,北京100070 [3]首都医科大学附属北京天坛医院神经外科,北京100070

出　　处：《中华医学杂志》2022年第39期3147-3150,共4页National Medical Journal of China

摘　　要：本研究报道2例大脑淋巴瘤病患者的临床诊疗经验。病例1,女,53岁;病例2,男,69岁。2例患者均以进行性认知功能障碍为主要临床表现。头颅磁共振成像提示脑白质病变伴有片状或团块样强化,脑灌注成像提示灌注减低。脑活检证实均为弥漫性大B细胞淋巴瘤。脑脊液白细胞介素-10明显升高,脑脊液流式细胞学阴性。提示在大脑淋巴瘤病诊断中,脑脊液白细胞介素-10是重要的生物学指标,而脑脊液流式细胞学诊断价值有限。患者可出现脑灌注减低。This article reported the clinical experience of diagnosis and treatment for two patients with lymphomatosis cerebri.Case 1 was female and aged 53 years old,while case 2 was male and aged 69 years old.Progressive cognitive impairment was the main clinical manifestation in both patients.Brain magnetic resonance imaging(MRI)suggested leukoencephalopathy with patchy or mass enhancement.Cerebral blood flow was reduced on perfusion imaging in one patient.Brain biopsy confirmed diffuse large B-cell lymphoma in both cases.The concentration of interleukin-10 in cerebrospinal fluid(CSF)of two patients was significantly increased,however,the result of CSF flow cytology was negative.The current study suggests that interleukin-10 in CSF is an important biological indicator for the diagnosis of lymphomatosis cerebri,but CSF flow cytometry may not be helpful.Moreover,cerebral hypoperfusion can be present in patients with lymphomatosis cerebri.

关 键 词：弥漫大B细胞淋巴瘤 脑白质病 认知障碍 淋巴瘤脑病 白细胞介素-10 

分 类 号：R739.41[医药卫生—肿瘤]