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脑淋巴瘤:90例临床及影像学表现

Cerebral lymphoma: clinical and radiological findings in 90 cases.

作者信息

Zali Alireza, Shahzadi Sohrab, Mohammad-Mohammadi Alireza, Taherzadeh Karim, Parsa Khosro

机构信息

Department of Neurosurgery, Shohada Hospital, Shaheed Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

Arch Iran Med. 2007 Apr;10(2):194-8.

Abstract

BACKGROUND

Cerebral lymphoma is a rare non-Hodgkin's lymphoma, which involves the brain primarily or after systemic involvement. Because of its infiltrating nature and its sensitivity to radio- and chemotherapy, surgical removal has a limited role in its treatment and only a stereotactic biopsy is necessary for confirming the diagnosis.

METHODS

The data from all cases in whom the cerebral lymphomas were pathologically confirmed and were admitted to the Neurosurgery Department of Shohada Hospital for stereotactic biopsy during a 15-year period were analyzed retrospectively.

RESULTS

The male to female ratio was 1.3:1 and the mean age was 51.7 years. Sixty-seven percent of the patients had multiple lesions and the remainder had solitary lesions. The most common site of involvement in patients with multiple lesions was diencephalon and in patients with solitary lesions was frontal lobe. The mean duration from symptom presentation to stereotactic biopsy was three months. Systemic lymphoma was detected in nine patients and three patients had a history of immunosuppressive drug consumption. The most common presenting symptom was headache in 42% and the most common sign was paresis in 59% of the patients. In 53 patients, follow-up was performed by phone call. Of these, seven cases had died without treatment in an average of 40 days after diagnosis, 28 patients died despite adjuvant treatment in an average of 8.5 months, and 18 cases were alive by the time of last follow-up with average of 17 months. Overall survival of the treated group was 12 months.

CONCLUSION

There was no mortality related to stereotactic biopsies in these patients.

摘要

背景

脑淋巴瘤是一种罕见的非霍奇金淋巴瘤,主要累及脑部或在全身受累后累及脑部。由于其浸润性以及对放疗和化疗的敏感性,手术切除在其治疗中的作用有限,确诊仅需进行立体定向活检。

方法

回顾性分析15年间在绍哈达医院神经外科因立体定向活检而病理确诊为脑淋巴瘤的所有病例的数据。

结果

男女比例为1.3:1,平均年龄为51.7岁。67%的患者有多处病灶,其余患者有单发病灶。多发病灶患者最常受累部位是间脑,单发病灶患者最常受累部位是额叶。从出现症状到进行立体定向活检的平均时间为3个月。9例患者检测出全身性淋巴瘤,3例患者有免疫抑制药物使用史。最常见的首发症状是头痛(42%),最常见的体征是轻瘫(59%)。53例患者通过电话进行随访。其中,7例未经治疗在诊断后平均40天死亡,28例尽管接受辅助治疗仍在平均8.5个月后死亡,18例在最后一次随访时存活,平均存活17个月。治疗组的总生存期为12个月。

结论

这些患者中没有与立体定向活检相关的死亡病例。

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