老年脑非霍奇金淋巴瘤的诊断治疗

Diagnosis and treatment of elder non-Hodgkin's malignant brain lymphoma

目的:探讨老年脑非霍奇金淋巴瘤的诊断和治疗方法。方法:分析5例脑非霍奇金淋巴瘤的临床特点、影像学特征及治疗效果。结果:本病常短期内出现高颅压症状且病情进展较快,MRIT1加权像肿瘤呈等或低信号,T2加权像呈高信号,增强扫描呈均一或握拳状强化。5例肿瘤中全切3例,近全切除、大部分切除各1例,术后均无新的脑局灶损害症状。3例术后给予大剂量MTX(3.5g/m2)为主的化疗+全脑放疗(30-40Gy),1例行化疗,随访4例15个月,3例现存活。结论:对脑非重要功能区的单发病灶、高颅压症状、肿瘤占位效应明显者应积极切除肿瘤,术后结合放化疗可有效控制肿瘤的局部复发率,提高患者远期生存率。

Objective：To explore the diagnosis and treatment of elder brain non-Hodgkin＇s lymphoma.Methods：To analyse the clincal characrsitic of image and treatment result of five cases of non-Hodgkin＇s lymphoma with surgical excision.Results：Hypointense on TI,hyperintense on T2 contrast-enhancing on MRI image.Total removal of tumors in three cases,one case of subtotal removal,one case with majority removal,no neurological deficit after surgery.Majortiy chemical treatment with large dose of MTX and with total brain radiation therapy in 3 case,1 case with chemical treatment long term follow up for 4 cases.3 cases survived.Conclusion：It should be actively craniotomy with tumor resection that the single lesions in the none important function district of brain,high intracranial pressure symptoms,mass effect cause ventricle pressure obviously,after surgery given chemotherapy and plus whole brain radiation therapy（30-40 Gy） can improve the long-term survival rate and decrease local tumor recurrence rate.