中枢神经系统原发性淋巴瘤32例临床分析

Clinical Analysis of Primary Lymphoma in Central Nervous System (Report of 32 Cases)

目的 探讨中枢神经系统原发性淋巴瘤的诊断、治疗方法选择及预后。方法 采用手术、病理及免疫组织化学方法证实32例淋巴瘤均来源于中枢神经系统,并进行临床分析。结果 中枢神经系统原发性淋巴瘤多位于颅内幕上,也可发生于椎管内,多呈浸润性生长,边界较清楚;影像学检查无特异性表现,确诊要靠病理检查;单纯手术不能延长患者的生存期,放疗和化疗有一定疗效,多数预后差。结论 中枢神经系统原发性淋巴瘤恶性程度高,发展快,早期手术、病理证实后采用放疗和化疗是延长患者生存期的关键。

Objective To explore the diagnosis, therapeutic option and prognosis of the primary lymphoma of the central nervous system (PLCNS). Method The data of 32 patients with PLCNS, which were confirmed by the operation and pathological and immunohistochemical examinations, were clinically analysed retrospectively. Results Most of the lymphomas were in the supratentorial region and some were in the vertebral canal. The majority of PLCNS invasively grew and had relatively distinct borders. The CT or MRI manifestations of PLCNS were nonspecific and its diagnosis was dependent on the pathological examination. The mere operation could not prolong the survival time in the patients with PLCNS. Although the some curative effects of the postoperative radiotherapy and chemotherapy on PLCNS were observed, the prognosis was poor in the most patients. Conclusion Early operation combined with radiotherapy and chemotherapy could properly prolong survival time in the patients with PLCNS.