慢性淋巴细胞白血病合并中枢神经系统侵犯一例报告并文献复习

Chronic lymphocytic leukemia with central nervous system invasion： one case report and literature review

目的 探讨慢性淋巴细胞白血病（CLL）侵犯中枢神经系统（CNS）的临床特点、诊治方法与预后.方法 报道1例CLL侵犯CNS患者,通过骨髓细胞学、脑脊液细胞形态学及流式细胞术、影像学等检查,结合文献复习,探讨其发病机制、诊断、治疗与预后特点.结果 患者脑脊液中检测出一群免疫表型符合CLL的单克隆性B淋巴细胞,经多次鞘内注射治疗后,脑脊液淋巴细胞减少,神经系统症状缓解.既往文献同样显示鞘内注射治疗对CLL患者CNS侵犯有效.结论 CNS侵犯是CLL的少见并发症,早期诊断及治疗可提高疗效.

Objective To investigate clinical features,diagnosis,therapy,and prognosis in a case of chronic lymphocytic leukemia （CLL） with central nervous system （CNS） invasion.Methods The cellular morphology of bone marrow,cytology and flow cytometry of cells in CSF,and radiographic manifestations were detected in a patient diagnosed as CLL with CNS invasion.The clinical features,pathogenesis,diagnosis,therapy,and prognosis of CLL with CNS invasion were reviewed by literatures.Results A clonal population of B lymphocytes with typical characteristics of immunophenotype was identified in the patient.After treated with intrathecal chemotherapy,the patient returned to normal cells count of cerebrospinal fluid and normal neurologic status.Previous studies also have demonstrated the efficacy of intrathecal chemotherapy.Conclusions CNS invasion is a rare complication of CLL.Early detection and treatment may result in better outcomes.