原发性中枢神经系统淋巴瘤32例临床分析

Clinical analysis of primary central nervous system lymphoma

目的探讨原发性中枢神经系统淋巴瘤(PCNSL)临床特点、诊治方案及临床疗效.方法回顾性分析1990年1月～2004年12月收治的PCNSL 32例.结果 1例经立体定向活检确诊,31例手术确诊.31例手术中全切或近全切除28例(90%),大部切除3例(10%),无手术死亡病例.病理检查:B细胞型淋巴瘤30例,T细胞型淋巴瘤2例.术后临床症状改善22例(69%),稳定6例(19%),症状加重4例(12%).术后辅以放射治疗25例,联合化疗9例.结论 PCNSL为少见恶性肿瘤,早期诊断,并进行有效的综合治疗是延长PCNSL患者生存期和改善生存质量的关键.

Objective To discuss the clinical characteristics, diagnosis and treatment of primary central nervous system lymphoma. Methods 32 cases with primary central nervous system lymphoma were reviewed. Results One case was diagnozed by biopsy and 31 cases by operation. Total or subtotal removal was achieved in 28 cases without death. The symptoms in 22 （69%） cases were relieved, 6 （19%） cases steady and 4 （12%） cases worsened. 25 cases were treated by radiotherapy after surgery, 9 cases combined with chemotherapy. Conclusion Primary central nervous system lymphoma is a rare malignant neoplasm. Eerly diagnosis and surgical removal of the tumors, and receiving effective radiotherapy and chemotherapy are the key to extending survial period and improving living quality of patients with primary central nervous system lypmhoma.