Nishimoto Takeshi, Yuki Kiyoshi, Sasaki Tomohiro, Imada Yasutaka, Murakami Tarou, Kodama Yasunori
Department of Neurosurgery, National Hiroshima Hospital, Hiroshima, Japan.
No Shinkei Geka. 2003 Jan;31(1):43-7.
A 63-year-old male was admitted to our hospital, complaining of a scalp mass located at the frontoparietal area of his head. He noticed that it had been growing for 2 months. The mass was elastic hard and non-moving. Computed tomography demonstrated a subcutaneous mass with low density and which was enhanced homogeneously. The skull just below the mass was slightly destroyed, but the structure remained. Magnetic resonance imaging (MRI) demonstrated a mass with low signal intensity on both the T1 weighted image and the T2 weighted image. Gd-DTPA study showed homogeneous enhancement and showed also that the dura just below the mass was enhanced. At this point we couldn't diagnose it confidently, but suspected this lesion to be a malignant lymphoma. We made a general examination, but no other lesion was found. A biopsy of the subcutaneous mass was performed under local anesthesia. The histological diagnosis was large-cell type B-Cell lymphoma. The tumor was treated with chemotherapy, CHOP (cyclophosphamid, doxorubicin, vincristin predonisolone). It responded to this chemotherapy and disappeared. We treated this lesion without radiation therapy. We report a case of subcutaneous malignant lymphoma treated successfully with a minimum invasive method.
一名63岁男性因头部额顶区头皮肿物入院。他注意到肿物已生长2个月。肿物质地硬如橡皮，固定不动。计算机断层扫描显示皮下肿物呈低密度，均匀强化。肿物下方颅骨稍有破坏，但结构尚存。磁共振成像（MRI）显示在T1加权像和T2加权像上肿物均呈低信号强度。钆喷酸葡胺（Gd-DTPA）检查显示均匀强化，还显示肿物下方硬脑膜强化。此时我们无法确诊，但怀疑该病变为恶性淋巴瘤。我们进行了全面检查，但未发现其他病变。在局部麻醉下对皮下肿物进行活检。组织学诊断为B细胞大细胞型淋巴瘤。肿瘤采用CHOP（环磷酰胺、阿霉素、长春新碱、泼尼松龙）化疗。对该化疗有反应，肿物消失。我们未采用放射治疗处理此病变。我们报告一例采用微创方法成功治疗的皮下恶性淋巴瘤病例。
