Peltier J, Fichten A, Lefranc M, Toussaint P, Desenclos C, Pruvot A-S, Nicot B, Le Gars D
Service de neurochirurgie, centre hospitalier universitaire d'Amiens, place Victor-Pauchet, 80054 Amiens cedex 1, France.
Neurochirurgie. 2009 Jun;55(3):345-9. doi: 10.1016/j.neuchi.2008.12.003. Epub 2009 May 9.
A case of a meningeal B-cell lymphoma is described. A 48-year-old man presented with an episode of grand mal seizure following a brain injury. An initial diagnosis of extradural hematoma was made based on the results of the cerebral computerized tomography scan. Magnetic resonance images demonstrated an enhanced mass with a dural tail attached to the meningeal layer of the temporal bone, suggesting a meningioma "en plaque". The mass was surgically excised. Tumoral removal was subcomplete (Simpson 2). Operative inspection also suggested a meningioma, but histological analysis and electron microscopy revealed a grade IV follicular B-cell lymphoma. Biological studies were normal. An extensive workup found an external iliac adenopathy with several osseous locations on PET. The patient underwent chemotherapy and radiotherapy. Three years after the first symptoms appeared, the patient is alive and free of symptoms. The clinicopathological features and treatments were discussed.
本文描述了一例脑膜B细胞淋巴瘤病例。一名48岁男性在脑损伤后出现一次癫痫大发作。根据脑部计算机断层扫描结果,初步诊断为硬膜外血肿。磁共振成像显示有一个强化肿块,伴有一条与颞骨脑膜层相连的硬膜尾征,提示为“扁平状”脑膜瘤。该肿块通过手术切除。肿瘤切除不完全(辛普森2级)。手术检查也提示为脑膜瘤,但组织学分析和电子显微镜检查显示为IV级滤泡性B细胞淋巴瘤。生物学检查正常。全面检查发现髂外淋巴结肿大,PET检查显示有多个骨转移部位。该患者接受了化疗和放疗。首次出现症状三年后,患者存活且无症状。文中讨论了其临床病理特征及治疗方法。