原发于中枢神经系统的B细胞性淋巴瘤14例

Clinical investigation about 14 cases of primary central nervous system B-cell lymphoma

目的提高对原发于中枢神经系统的B细胞性淋巴瘤的认知和诊治水平。方法回顾性分析27 a间兰州军区兰州总医院神经外科经手术和病理证实的14例恶性B细胞性淋巴瘤的临床资料。结果 14例恶性B细胞性淋巴瘤中,术前诊断考虑到淋巴瘤的仅3例。9例接受了手术和辅助治疗,2例采用X刀治疗和化学治疗,3例单纯化学治疗。术后病理结果为:神经系统孤立的髓外浆细胞瘤2例,浆细胞性骨髓瘤2例,弥漫性大B细胞性淋巴瘤10例。6例生存,3例死亡,5例失访。结论原发于中枢神经系统的B细胞性淋巴瘤并不多见,诊断主要依靠病理学结果,手术是主要的治疗手段,术后结合放射治疗和化学治疗是必要的。

Objective To improve the cognition and the therapy level of primary central nervous system B-cell lymphoma.Methods The clinical data of 14 cases of malignant B-cell lymphoma proved by operation and pathology from Department of Neurosurgery in Lanzhou General Hospital during the past 27 years was reviewed and analyzed.Results In the 14 cases of malignant B-cell lymphoma,only 3 cases were allowed for lymphoma before operation.Nine cases accepted operation and chemoradiation.Two cases accepted X-knife and chemotherapy.Three cases only accepted chemotherapy.The pathology result after operation showed that 2 cases with extramedullary plasmacytoma infiltrating the central nervous system,2 cases with plasma cell myeloma and 10 cases with solitary intracranial diffuse big B-cell lymphoma.There were six cases survival,3 cases death and 5 cases out of follow-up.Conclusion Incidence is few in primary central nervous system malignant B-cell lymphoma.The diagnosis depends on pathological result.Surgery is the optimal way and aided chemoradiation for it is necessary.