中枢神经系统原发性恶性淋巴瘤13例分析

A retrospective analysis of 13 cases central nervous system primary malignant lymphoma

目的回顾性分析１３例中枢神经系统原发性恶性淋巴瘤（ＣＰＭＬ）患者的临床资料。方法对本病的临床、实验室、影像学及病理学检查进行分析。结果发现ＣＰＭＬ患者的临床表现复杂，颅高压和神经系统缺损的症状和体征为主要表现；脑脊液中蛋白定量增高，肿瘤可呈单发或多发，以额叶和颞叶多见。ＣＰＭＬ的病理形态学与身体其他部位的恶性淋巴瘤颇相似，绝大多数起源于Ｂ淋巴细胞。结论ＣＰＭＬ的临床或影像学均缺乏特异性表现，早期诊断十分困难。

Objective To analyse 13 cases of central nervous system primary malignant lymphoma(CPML). Method The clinical, laboratory, neuroradiological and pathological data of 13 cases of CPML were analysed. Results The common clinical findings of CPML consisted of increased intracranial pressure, seizures, impaired cortical function and focal neurologic deficits. Studies of CSF revealed protein elevations in excess of 1.0 g/L in all of the patients who had lumbar punctures. Neuroradiological examinations with CT and MRI both showed solitary or multiple intracranial masses of tumor located particularly in the frontal and temporal lobes. Pathological examination showed that lymphomas arising in CNS were morphologicaly similar to those originating elsewhere in the other patients′ bodies. The greater majority of CPML had been of Bcell origin. Conclusion The patients of CPML usually did not show characteristic clinical manifestations or findings in imaging scanning unless there were specific complications. A new approach in the diagnosis of this disease with the use of brain biopsy pathological examination might be the more reliable method to confirm this disorder.