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[一例原发性中枢神经系统淋巴瘤病例报告,起病前脑和小脑病变自发减轻:关于发病时及两年后两次脑活检的思考]

[A case report of primary central nervous system lymphoma preceded by cerebral and cerebellar lesion diminishing spontaneously: consideration of two brain biopsy at the onset and after two years].

作者信息

Suzuki Makiko, Uchiyama Tsuyoshi, Takahashi Hitoshi, Ito Michiko, Shimizu Takako, Kobayashi Hiroshi, Ohashi Toshihiko

机构信息

Department of Neurology, Seirei Hamamatsu General Hospital.

出版信息

Rinsho Shinkeigaku. 2009 Sep;49(9):586-9. doi: 10.5692/clinicalneurol.49.586.

Abstract

A 57-year-old man suffered a generalized seizure. Brain MRI showed a Gadolinium (Gd) enhanced lesion with massive edema in the left frontal lobe. He received in a brain biopsy a diagnosis of ganglioglioma, probable. After two weeks from the biopsy, brain MRI showed spontaneous remmision of the lesion. Eighteen months after his seizure, a follow-up brain MRI showed a new lesion in the left cerebellar peduncle. However, the lesion also improved spontaneously. After 2 years from the onset, a follow-up examination showed a new lesion in the corpus callosum. At that time even though high dose corticosteroid was given with the diagnosis of multiple sclerosis, the lesion enlarged progressively and uveitis occurred at the same time. He received in the second biopsy a diagnosis of diffuse large B cell lymphoma We report a case of primary central nervous system lymphoma preceded by cerebral and cerebellar lesion diminishing spontaneously, with consideration of two brain biopsy at the onset and after two years.

摘要

一名57岁男性发生全身性癫痫发作。脑部磁共振成像(MRI)显示左侧额叶有一个钆(Gd)增强病灶,并伴有大量水肿。他接受了脑活检,初步诊断为可能的神经节胶质瘤。活检两周后,脑部MRI显示病灶自发缓解。癫痫发作18个月后,随访脑部MRI显示左侧小脑脚出现一个新病灶。然而,该病灶也自发改善。发病2年后,随访检查显示胼胝体出现一个新病灶。当时,尽管诊断为多发性硬化症并给予了高剂量皮质类固醇治疗,但病灶仍逐渐增大,同时出现了葡萄膜炎。他接受了第二次活检,诊断为弥漫性大B细胞淋巴瘤。我们报告一例原发性中枢神经系统淋巴瘤病例,其之前脑部和小脑病灶曾自发缩小,且在发病时及两年后均进行了两次脑活检。

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