原发性脑非霍奇金淋巴瘤临床及MRI诊断

Clinicopathological and MRI diagnosis and differentiation of primary brain lymphoma

目的 :分析原发性脑淋巴瘤临床病理资料和MRI表现 ,以提高对该病的诊断与鉴别诊断能力。方法 :回顾性分析 5例经病理证实的脑原发性淋巴瘤的临床病理资料和MRI表现。结果 :本组单发 3例 ,多发 2例。病理类型均为B细胞型非霍奇金淋巴瘤 ,3例为中心母细胞型 ,2例为小细胞型。MRI显示肿瘤呈长T1、长T2 信号 ,增强后瘤体呈明显团块或结节状强化、无囊变及环形强化。患者的生存时间在 6月～ 3年以上。结论 :原发性脑淋巴瘤无特征性临床和MR表现 ,瘤体可单发或多发 ,呈团块状或结节状均匀强化 ,其预后与组织类型有关 。

Objective:To study the histogenesis and MRI features of primary malignant lymphoma of the brain. Methods: Clinical characteristics and MRI findings of primary brain lymphoma in 5 patients with pathological provement were retrospectively analyzed.Results:The lesions were solitary in 3 cases and multiple in 2 cases.Pathologically,all of the 5 cases were non-Hodgkin's B cell type lymphoma.There were 2 cases of centroblastic cell type,one case of centrocyticl centroblastic cell type,and 2 cases of small cell type.On MRI,the lesions displayed long T_1 and long T_2 signal,which were markedly enhanced after contrast injection without cystic degeneration or ring-like enhancement.The survival time rangeed from 6 months to more than three years.Conclusion:Primary brain lymphoma shows no characteristic MR findings.The lesion may be solitary or multiple,displaying homogeneous enhancement after contrast injection.The prognosis of primary malignant lymphoma in the brain is related to its type.Immunohistochemistry is an important method in diagnosing brain lymphoma.