Lai A P, Wierzbicki A S, Norman P M
Department of Haematology, National Hospital for Nervous Diseases, London.
J Clin Pathol. 1991 Mar;44(3):251-3. doi: 10.1136/jcp.44.3.251.
Four men with primary cerebral non-Hodgkin's lymphoma diagnosed by immunocytological analysis of cerebrospinal fluid (CSF) presented with cranial nerve palsies. All had CSF lymphocytoses and low CSF glucose. The cell phenotypes were two T cell tumours, one B cell, and one null. A review of 13 previously recorded cases of immunocytologically diagnosed CNS non-Hodgkin's lymphoma showed that there were 10 B cell, two T cell, and one null tumour. Overall (17 cases) the cell phenotype distribution was 65% B cell, 24% T cell, and 11% null. High CSF lymphocyte counts were found in 94%, proteinosis in 85%, and low CSF glucose in 87%. In contrast to the B cell tumours, all of the T cell tumours were diagnosed by CSF cytology before being visualised radiologically. It is suggested that all CSF lymphocytes (greater than 5 x 10(6)/ml) should be immunohistochemically typed to permit earlier diagnosis of CNS non-Hodgkin's lymphoma.
通过脑脊液(CSF)免疫细胞分析诊断为原发性脑非霍奇金淋巴瘤的4名男性患者出现了颅神经麻痹。所有患者脑脊液淋巴细胞增多且脑脊液葡萄糖含量低。细胞表型为2例T细胞肿瘤、1例B细胞肿瘤和1例无标记细胞肿瘤。对13例先前记录的经免疫细胞分析诊断的中枢神经系统非霍奇金淋巴瘤病例进行回顾发现,有10例B细胞肿瘤、2例T细胞肿瘤和1例无标记细胞肿瘤。总体而言(17例),细胞表型分布为B细胞65%、T细胞24%、无标记细胞11%。94%的患者脑脊液淋巴细胞计数高,85%有蛋白增多,87%脑脊液葡萄糖含量低。与B细胞肿瘤不同,所有T细胞肿瘤在影像学显示之前均通过脑脊液细胞学诊断。建议对所有脑脊液淋巴细胞(大于5×10⁶/ml)进行免疫组织化学分型,以便更早诊断中枢神经系统非霍奇金淋巴瘤。