原发性中枢神经系统淋巴瘤临床分析

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)的临床特征。方法:回顾分析10例免疫功能正常的PCNSL患者的临床资料。结果:临床表现为颅内压增高及病灶所致的局部表现。病灶单发7例,多发3例,全经手术切除病灶,病理示B细胞型非霍奇金淋巴瘤。6例术后未行放化疗出院,失访1例,随访5例,平均生存4个月。1例CHOP方案化疗1周期,生存19个月。3例行大剂量甲氨蝶呤化疗+放疗;1例生存13个月,2例至今生存,平均生存24个月,复查无异常。结论:PCNSL预后不良,单纯手术不能延长患者生存期,手术结合放化疗是目前临床首选的治疗方案。

Objective：To investigate the clinical features of primary central nervous system lymphoma （PCNSL）. Methods：The clinical data of 10 immunocompetent PCNSL patients were analyzed retrospectively. Results：The clinical presentations were symptoms of intracranial hypertension and corresponding neurofunctional disorders due to various locations of the tumors. Seven were with single lesion and 3 multiple. All of them underwent operations and the histopathological types were B cells non-Hodgkin type. Six cases were discharged just after operations,5 of them were follow-up,the mean survival time was 4 months. One case received 1 course of CHOP and survived for 19 months. Three patients completed high-dose methotrexate combined with radiotherapy,1 just survived for 13 months,but 2 survived until now and the mean survival time was 24 months. There were no abnormalities during their regular follow-up observation. Conclusions：The prognosis of PCNSL is poor. Patient＇s survival time can＇t be prolonged by the operation. The update strategy of choice is still resection followed by chemotherapy and radiotherapy.