Primary cerebral lymphoma (PCL) is a form of extranodal non-Hodgkin’s lymphoma with a poor prognosis. Very few cohorts have been reported in the literature. It is a rare form in 1% of extranodal lymphomas, and 3%...Primary cerebral lymphoma (PCL) is a form of extranodal non-Hodgkin’s lymphoma with a poor prognosis. Very few cohorts have been reported in the literature. It is a rare form in 1% of extranodal lymphomas, and 3% to 4% of brain tumors. The most common histological type is diffuse large B-cell lymphoma. Survival is improved by combining immunotherapy with chemotherapy. This is a descriptive retrospective study conducted at the Casablanca hematology center over a period of 9 years. The aim of this study was to report our experience by studying the clinical, paraclinical, therapeutic and evolutionary profile of patients with primary cerebral lymphoma. We present a study of 22 patients with PCL. The clinical, radiological and histological findings are shown along with the results of treatment. Patients were aged 25 - 75 years (mean 47 years) with a male predominance (77%). Computed tomography (CT) scans were performed on 16 patients (73%) and Brain magnetic resonance imaging for 16 patients (73%). Typically, lesions were multiple, isodense, and showed uniform enhancement with contrast medium. Immunocytochemical studies demonstrated 21 B-cell and 1 mantle-cell lymphomas. All patients received chemotherapy through high-dose MTX with whole brain radiotherapy (WBRT). After a median follow-up of 19 months, 54% are in complete remission, 32% have died, and 14% are lost to follow-up. Overall survival at 24 months and 36 months were 72% and 52%. The event-free survival at 24 months and 36 months were 60% and 48%. This study was to investigate the clinical features of PCNSL, and evaluate the efficacy of high-dose methotrexate (MTX)-based chemotherapy for immunocompetent Moroccan patients with PCNSL.展开更多
目的探讨^(18)F-FDG PE_(T/C)T鉴别诊断原发性中枢神经系统淋巴瘤(primary central nervous system lymphoma,PCNSL)及颅内多发胶质瘤(multifocal cerebral gliomas,MCG)的应用价值。方法回顾性收集2015年1月~2021年7月于首都医科大学...目的探讨^(18)F-FDG PE_(T/C)T鉴别诊断原发性中枢神经系统淋巴瘤(primary central nervous system lymphoma,PCNSL)及颅内多发胶质瘤(multifocal cerebral gliomas,MCG)的应用价值。方法回顾性收集2015年1月~2021年7月于首都医科大学附属北京天坛医院就诊并由穿刺活检病理证实的多发PCNSL患者(L组)和MCG患者(G组)的临床数据及影像学资料共55例,均行全身^(18)F-FDG PE_(T/C)T检查,包括:L组28例(病灶95个)及G组27例(病灶65个)。采用卡方检验比较两组病变发病部位差异;独立样本t检验对比分析肿瘤PET代谢参数SUVmax(SUVmax-_(T))及其与小脑灰质、大脑白质、大脑灰质的比值(SUVmax-_(T/C),SUVmax-_(T/W),SUVmax-_(T/G))以及病灶密度相关参数的差异;受试者工作特征曲线(receiver operator characteristic curve,ROC曲线)分析参数诊断效能并计算截断值;Pearson相关性分析对两组病灶实性密度CT值与SUVmax进行分析。结果L组易累及中线及脑室旁结构,G组易发生囊变坏死,L组肿瘤代谢活性参数高于G组(P<0.05)。以病灶为单位进行ROC曲线分析,结果显示,SUVmax、SUVmax-_(T/C)、SUVmax-_(T/W)及SUVmax-_(T/G)的截断值、敏感性及特异性分别为:16.62、72.6%、87.7%,1.84、73.7%、90.8%,4.70、73.7%、84.6%,1.49、75.8%、92.3%;以患者为单位进行ROC曲线分析,结果显示,SUVmax、SUVmax-_(T/C)、SUVmax-_(T/W)及SUVmax-_(T/G)的截断值、敏感性及特异性分别为:18.18、89.3%、88.9%,2.11、89.3%、92.6%,5.76、85.7%、85.2%,1.62、92.9%、82.6%;P均<0.05。两组病变密度参数差异无统计学意义(P>0.05)。L组病变实性部分SUVmax与密度具有弱相关性(P<0.05),G组无明显相关性(P>0.05)。结论^(18)F-FDG PE_(T/C)T在多发PCNSL和颅内多发胶质瘤鉴别诊断中具有重要应用价值。展开更多
文摘Primary cerebral lymphoma (PCL) is a form of extranodal non-Hodgkin’s lymphoma with a poor prognosis. Very few cohorts have been reported in the literature. It is a rare form in 1% of extranodal lymphomas, and 3% to 4% of brain tumors. The most common histological type is diffuse large B-cell lymphoma. Survival is improved by combining immunotherapy with chemotherapy. This is a descriptive retrospective study conducted at the Casablanca hematology center over a period of 9 years. The aim of this study was to report our experience by studying the clinical, paraclinical, therapeutic and evolutionary profile of patients with primary cerebral lymphoma. We present a study of 22 patients with PCL. The clinical, radiological and histological findings are shown along with the results of treatment. Patients were aged 25 - 75 years (mean 47 years) with a male predominance (77%). Computed tomography (CT) scans were performed on 16 patients (73%) and Brain magnetic resonance imaging for 16 patients (73%). Typically, lesions were multiple, isodense, and showed uniform enhancement with contrast medium. Immunocytochemical studies demonstrated 21 B-cell and 1 mantle-cell lymphomas. All patients received chemotherapy through high-dose MTX with whole brain radiotherapy (WBRT). After a median follow-up of 19 months, 54% are in complete remission, 32% have died, and 14% are lost to follow-up. Overall survival at 24 months and 36 months were 72% and 52%. The event-free survival at 24 months and 36 months were 60% and 48%. This study was to investigate the clinical features of PCNSL, and evaluate the efficacy of high-dose methotrexate (MTX)-based chemotherapy for immunocompetent Moroccan patients with PCNSL.
