原发性中枢神经系统恶性淋巴瘤临床病理分析

Clinicopathological features of primary central nervous system malignant lymphoma

目的:探讨原发性中枢神经系统恶性淋巴瘤(PCNSML)的临床病理特征。方法:总结本院9例临床病理资料并复习近10年来国内发表的415例PCNSML。结果:PCNSML好发于50～60岁,男女之比为1.4∶1;临床表现以颅内压增高及相应脑功能区损害症状(偏瘫截瘫、肢体乏力、精神症状)为主;镜下肿瘤细胞形态单一,呈弥漫性浸润,小血管周围肿瘤细胞呈袖套状排列;B细胞性占90.9%(281/309),T细胞性占9.1%(28/309)。结论:PCNSML最常见为B细胞性,推测为生发中心B细胞来源的肿瘤。免疫组化在PCNSML的诊断与鉴别诊断中起着重要作用。

Objective To investigate the clinicopathological features of primary central nervous system malignant lymphoma (PCNSML). Methods The clinicopathological informations of 9 cases of PCNSML in our hospital were collected and 415 cases of PCNSML reported by domestic authors in the past 10 years were reviewed. Results PCNSML predominantly occurred in the patients about 50-60 years old with the man and woman ratio of 1.4:1. The clinical manifestations mainly were the signs of elevated intracranial pressure and neurologic dysfunction ( hemiparalysis,weakness of limbs,neuropsychiatric symptoms). The morphology of the tumor cells was single. The tumor cells spread around the vessels so-called cuff in which B-cell type was 90.9%(281/309) and T-cell type was 9.1%(28/309). Conclusions PCNSML mainly manifests B-cell type, which suggests PCNSML may be of putative germinal center B-cell origin. Histopathological findings and immunohistochemistry play an important role in the diagnosis of PCNSML.