两例大脑淋巴瘤病患者的脑脊液改变及影像学特征

Imaging and cerebrospinal fluid features of two cases with lymphomatosis cerebri

本研究报道2例大脑淋巴瘤病患者的临床诊疗经验。病例1,女,53岁;病例2,男,69岁。2例患者均以进行性认知功能障碍为主要临床表现。头颅磁共振成像提示脑白质病变伴有片状或团块样强化,脑灌注成像提示灌注减低。脑活检证实均为弥漫性大B细胞淋巴瘤。脑脊液白细胞介素-10明显升高,脑脊液流式细胞学阴性。提示在大脑淋巴瘤病诊断中,脑脊液白细胞介素-10是重要的生物学指标,而脑脊液流式细胞学诊断价值有限。患者可出现脑灌注减低。

This article reported the clinical experience of diagnosis and treatment for two patients with lymphomatosis cerebri.Case 1 was female and aged 53 years old,while case 2 was male and aged 69 years old.Progressive cognitive impairment was the main clinical manifestation in both patients.Brain magnetic resonance imaging(MRI)suggested leukoencephalopathy with patchy or mass enhancement.Cerebral blood flow was reduced on perfusion imaging in one patient.Brain biopsy confirmed diffuse large B-cell lymphoma in both cases.The concentration of interleukin-10 in cerebrospinal fluid(CSF)of two patients was significantly increased,however,the result of CSF flow cytology was negative.The current study suggests that interleukin-10 in CSF is an important biological indicator for the diagnosis of lymphomatosis cerebri,but CSF flow cytometry may not be helpful.Moreover,cerebral hypoperfusion can be present in patients with lymphomatosis cerebri.