Yang C P, Wan Y L, Hung I J
Department of Medicine, Chang Gung Children's Hospital, Taoyuan, Taiwan.
J Formos Med Assoc. 1999 Jan;98(1):66-9.
Burkitt's lymphoma, the most common childhood non-Hodgkin's lymphoma, usually presents with abdominal tumors. Central nervous system (CNS) involvement in Burkitt's lymphoma is mostly secondary to advanced systemic disease, rarely with brain parenchymal lesions, and was previously recalcitrant to treatment. We report an unusual case of CNS Burkitt's lymphoma with minimal extraneural disease. This 10-year-old immunocompetent boy presented with increased intracranial pressure and seizures and was found to have multifocal intracerebral lesions on brain imaging studies. Cerebrospinal fluid studies confirmed the presence of Burkitt's lymphoma cells. Abdominal computed tomography showed bilateral nephromegaly with left intrarenal lesions that disappeared after three doses of intravenous dexamethasone. The patient was treated for 6.5 months according to the LMB 89 group C protocol of the French Pediatric Oncology Society. The response was brisk and complete. The patient has been disease free for more than 4 years, and is believed to be cured.
伯基特淋巴瘤是最常见的儿童非霍奇金淋巴瘤，通常表现为腹部肿瘤。伯基特淋巴瘤累及中枢神经系统（CNS）大多继发于晚期全身性疾病，很少出现脑实质病变，且以前对治疗反应不佳。我们报告一例不寻常的CNS伯基特淋巴瘤病例，其神经外疾病极少。这个10岁免疫功能正常的男孩出现颅内压升高和癫痫发作，脑部影像学检查发现有多发性脑内病变。脑脊液检查证实存在伯基特淋巴瘤细胞。腹部计算机断层扫描显示双侧肾肿大，左侧肾内有病变，静脉注射三剂地塞米松后病变消失。该患者按照法国儿科肿瘤学会的LMB 89 C组方案接受了6.5个月的治疗。反应迅速且完全缓解。该患者已无病生存超过4年，被认为已治愈。
