原发性中枢神经系统淋巴瘤CT、MRI表现及临床病理特征

CT and MRI features of primary central nervous system lymphoma and clinical pathological analysis

目的：探讨原发性中枢神经系统淋巴瘤的影像学表现、诊断和病理学特点。方法：对35例病理诊断为原发性中枢神经系统淋巴瘤患者的临床资料进行回顾性分析。结果：原发性中枢神经系统淋巴瘤多以颅内高压症状起病,并伴有共济失调症状;MRI表现为等或稍长T_1信号、等或稍长T_2信号,增强扫描呈均匀强化,可形成＂缺口征＂、＂握拳征＂、＂尖角征＂等特征性表现;多表达B细胞或T细胞标记物,肿瘤增殖抗原（Ki67）阳性率为30%~95%。结论：原发性中枢神经系统淋巴瘤临床表现无特殊,但影像学及免疫组化表现具有特征性。需与脑转移瘤、胶质瘤、脑膜瘤及脑脓肿鉴别。

Objective：The incidence of the primary central nervous system lymphoma was low,which was reported less,This paper discusses the imaging findings,diagnosis,pathology.Methods：A retrospective analysis of 35 cases diagnosed pathologically as the central nervous system lymphoma,who underwent surgical treatment,according to the imaging findings,pathological diagnosis and prognosis were analyzed carefully.Results：The onset of increased intracranial pressure symptoms first indicated the primary central nervous system lymphoma,maybe accompanied with ataxia symptoms.MRI showed slightly long T_1W1 or slightly longer or T_2W2 signal,with homogenous enhancement that might display the specific performance of the gap sign,the cusp sign or the fist sign.Diffusion weighted imaging（DWI）showed mostly uniform hyperintense,The tumor cells expressed B-cell or T-cell markers.The human nuclear cell proliferation-associated antigen（Ki67）-positive rate varied from 30% to 95%.Conclusion：The clinical manifestations of the primary central nervous system lymphoma are difficult to differentiate with other tumors.The imaging performance having a certain degree of specificity.Pathology and immunohistochemistry has its unique performance.