Pascual J M, González-Llanos F, Roda J M
Unit of Neurosurgery, Clínica Moncloa, Madrid.
Neurocirugia (Astur). 2002 Aug;13(4):305-10. doi: 10.1016/s1130-1473(02)70605-2.
Primary central nervous system lymphomas (PCNSL) are infrequent tumors and their presentation as a solitary hypothalamic-third ventricle mass can be considered exceptional. We report the case of a 57-year-old woman with progressive visual deterioration, diabetes insipidus and mental confusion. She had a diffuse and homogeneous tumoral lesion involving the third ventricle and the adjacent hypothalamic area with marked enhancement after contrast administration on both, competed tomography scan and magnetic resonance images. It was approached and partially resected by the translamina terminalis route. Histological diagnosis proved to be a diffuse non-Hodgkin lymphoma and the patient subsequently was treated with adjuvant radiotherapy and chemotherapy. Followup examination showed visual acuity recover but persistent confessional state. Eight similar well described cases reported in the literature are reviewed with a description of the major diffenciating features of this neurological entity. Treatment of PCNSL remains a challenge, and the topographical location within the hypothalamic-third ventricle area is even more complex.
原发性中枢神经系统淋巴瘤（PCNSL）是一种罕见的肿瘤，其表现为孤立的下丘脑-第三脑室肿块可被视为异常情况。我们报告一例57岁女性患者，有进行性视力减退、尿崩症和精神错乱。她在计算机断层扫描和磁共振成像上均显示第三脑室及相邻下丘脑区域有弥漫性均匀肿瘤病变，增强造影后有明显强化。通过终板入路对其进行了手术并部分切除。组织学诊断为弥漫性非霍奇金淋巴瘤，患者随后接受了辅助放疗和化疗。随访检查显示视力恢复，但精神状态持续存在。本文回顾了文献中报道的8例类似的详细病例，并描述了该神经疾病的主要鉴别特征。PCNSL的治疗仍然是一项挑战，而下丘脑-第三脑室区域内的肿瘤位置更为复杂。
