侵及马尾神经的原发性神经淋巴瘤病1例报告及文献复习

Primary neurolymphomatosis of the cauda equina(report of one case and review of literature)

目的探讨原发性神经淋巴瘤病(NL)的临床特征、诊断要点及治疗方法。方法回顾性分析1例侵及马尾神经的原发性神经淋巴瘤病患者的临床资料;结合患者的临床表现、影像学特征、病理学检查结果,对相关文献进行总结复习。结果本例患者为侵及马尾神经的原发性神经淋巴瘤病,主要表现为马尾综合征;通过组织活检明确诊断,病理诊断为弥漫大B细胞淋巴瘤(WHOⅣ级)。结论原发性神经淋巴瘤病临床罕见,早期诊断困难。当怀疑是此病时,应尽早进行组织活检;大剂量静脉注射甲氨蝶呤是目前首选的治疗方法。

Objective To explore the clinical features,diagnosis and treatment of primary neurolymphomatosis(NL).Methods The clinical data of one patient with primary NL of the cauda equina were analyzed retrospectively.Combined with clinical manifestations,imaging features and pathological examination results,the relevant literature were summarized and reviewed.Results The patient was diagnosed as primary NL of the cauda equina by biopsy and pathologic diagnosis confirmed diffuse large B-cell lymphoma(WHO GradeⅣ).Conclusions Primary NL is rare and difficult to diagnose in its early stages.When NL is highly suspected,biopsy should be performed as soon as possible.High-dose intravenous methotrexate is the first choice at present.