Kästner F, Paulus W, Deckert M, Schlegel P, Evers S, Husstedt I W
Klinik und Poliklinik für Neurologie, Universitätsklinikum, Albert-Schweitzer-Strasse 33, 48129 Münster.
Nervenarzt. 2007 Apr;78(4):451-6. doi: 10.1007/s00115-007-2255-7.
We present a 31-year-old female patient with primary non-Hodgkin's lymphoma of the CNS after immunosuppressive therapy. Colitis ulcerosa had been diagnosed 2 years previously. Prophylactic therapy with azathioprine over 9 months was stopped after the development of listeria meningitis which was treated successfully with antibiotics. At this time native CCT was normal. Three months later the patient developed an epileptic seizure and multiple cerebral lesions were detected in CCT and MRI. Although antibiotic therapy was started, the cerebral lesions showed no regression. Stereotactic biopsy revealed immunochemical and histologic high-grade malignant B cell lymphoma. The risk of primary CNS lymphoma under azathioprine treatment for an autoimmune disease with a possible congenital immunodeficiency is presented and the literature is reviewed.
我们报告一名31岁女性患者，在接受免疫抑制治疗后发生中枢神经系统原发性非霍奇金淋巴瘤。患者2年前被诊断为溃疡性结肠炎。在发生李斯特菌脑膜炎后，停用了9个月的硫唑嘌呤预防性治疗，该脑膜炎经抗生素治疗成功。此时头颅计算机断层扫描（CCT）正常。三个月后，患者出现癫痫发作，CCT和磁共振成像（MRI）检查发现多个脑病变。尽管开始了抗生素治疗，但脑病变并未消退。立体定向活检显示为免疫化学和组织学高度恶性B细胞淋巴瘤。本文介绍了在可能存在先天性免疫缺陷的自身免疫性疾病患者接受硫唑嘌呤治疗时发生原发性中枢神经系统淋巴瘤的风险，并对相关文献进行了综述。
