Porto L, Kieslich M, Schwabe D, Yan B, Zanella F E, Lanfermann H
Neuroradiology Department, Klinikum der Johann Wolfgang Goethe-Universität, Frankfurt am Main, Germany.
Pediatr Hematol Oncol. 2005 Apr-May;22(3):235-46. doi: 10.1080/08880010590921612.
This paper describes the rare MR and CT features of central nervous system (CNS) lymphoma in immunocompetent children and in survivors of childhood acute lymphoblastic leukemia (ALL) and discusses the causative role of cranial irradiation and/or leukoencephalopathy preceding central nervous system (CNS) lymphoma in survivors of childhood leukemia. The authors reviewed MR and CT scans of 3 children with biopsy-proved CNS lymphoma. One child had tumor infiltration within the optic nerve sheaths and optic chiasm by previously known non-Hodgkin lymphoma. In 2 patients, CNS lymphoma developed 8 and 10 years after initial ALL treatment. In both cases CNS lymphoma was preceded by cranial irradiation and leukoencephalopathy. A single lesion was present in 3 out of 4 patients. All lesions were isointense or hypointense on the T1-weighted images relative to gray matter and showed homogeneous enhancement. One lesion was centered in the central gray matter, one lesion was centered within a cerebral hemisphere, one lesion was in optic nerve, and there were 2 parasellar lesions. CNS lymphoma has a variable appearance in children. Knowledge of risk factors in children may help in the early recognition of disease, allowing for timely intervention. This may prompt early biopsy or a conservative management in the appropriate clinical setting.
本文描述了免疫功能正常儿童及儿童急性淋巴细胞白血病（ALL）幸存者中枢神经系统（CNS）淋巴瘤罕见的磁共振成像（MR）和计算机断层扫描（CT）特征，并探讨了头颅放疗和/或白质脑病在儿童白血病幸存者发生中枢神经系统（CNS）淋巴瘤之前所起的致病作用。作者回顾了3例经活检证实为中枢神经系统淋巴瘤患儿的MR和CT扫描结果。1例患儿的视神经鞘和视交叉内有先前已知的非霍奇金淋巴瘤肿瘤浸润。在2例患者中，中枢神经系统淋巴瘤在初次ALL治疗后8年和10年发生。在这两例中，中枢神经系统淋巴瘤之前均有头颅放疗和白质脑病。4例患者中有3例存在单个病灶。所有病灶在T1加权图像上相对于灰质呈等信号或低信号，并显示均匀强化。1个病灶位于中央灰质，1个病灶位于脑半球内，1个病灶位于视神经，还有2个鞍旁病灶。中枢神经系统淋巴瘤在儿童中的表现各异。了解儿童的危险因素可能有助于早期识别疾病，从而及时进行干预。这可能促使在适当的临床情况下尽早进行活检或采取保守治疗。
