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[以额部肿块生长为表现的原发性颅骨恶性淋巴瘤;病例报告]

[Primary malignant lymphoma of the skull presenting as a growing mass in the forehead; a case report].

作者信息

Kumon Y, Sakaki S, Nakano K, Fukui K, Kohno H, Kurihara K

机构信息

Department of Neurosurgery, Uwajima City Hospital.

出版信息

No Shinkei Geka. 1991 Mar;19(3):279-83.

PMID:2038420
Abstract

A rare case of primary malignant lymphoma of the skull was reported. A 74-year-old woman was admitted to our hospital complaining of a growing mass in her forehead where she had had minor trauma one month previously. On admission, neurological findings were normal and an elastic hard tumor (6 x 6 x 2 cm) was found in the right frontal region. Computed tomography (CT) showed a large soft tissue mass in the subcutaneous tissue and a small mass in the ethmoid sinus, with erosion at the inner and outer tables of the frontal bone. Magnetic resonance imaging revealed a low intensity area in the bone marrow beneath the tumor. Right carotid angiography showed that the tumor was fed by branches of the ophthalmic artery in the arterial phase and stained in the capillary phase. Partial excision of the tumor was performed, but the affected bone was left because of her advanced age, even though thinning and spicular formation of the frontal bone were observed beneath the tumor in places. Pathological examination showed the tumor to be a malignant lymphoma of non-Hodgkin and diffuse mixed type. Postoperatively, systemic examinations were performed by 99mTechnetium-MDP bone scanning, 67Gallium citrate scanning, bone marrow puncture, and CT scanning, without any evidence of systemic lymphoma. The patient received postoperative chemotherapy with Cyclophosphamide, Doxorubicin HCl, Vindesine Sulfate, Prednisolone, and complete remission has been achieved for the 8 months since the operation.

摘要

报告了一例罕见的原发性颅骨恶性淋巴瘤病例。一名74岁女性因一个月前前额部有轻微外伤后出现肿物增大而入住我院。入院时,神经系统检查正常,在右额部发现一个弹性硬的肿瘤(6×6×2cm)。计算机断层扫描(CT)显示皮下组织有一个大的软组织肿物,筛窦有一个小肿物,额骨内外板有侵蚀。磁共振成像显示肿瘤下方骨髓有一个低强度区域。右侧颈动脉血管造影显示肿瘤在动脉期由眼动脉分支供血,在毛细血管期有染色。对肿瘤进行了部分切除,但由于患者年龄较大,尽管在肿瘤下方的额骨处局部观察到骨质变薄和针状形成,仍保留了受累骨质。病理检查显示肿瘤为非霍奇金弥漫混合型恶性淋巴瘤。术后,通过99m锝-亚甲基二膦酸盐骨扫描、枸橼酸镓扫描、骨髓穿刺和CT扫描进行了全身检查,未发现任何系统性淋巴瘤的证据。患者术后接受了环磷酰胺、盐酸多柔比星、硫酸长春地辛、泼尼松龙化疗,自手术以来8个月已实现完全缓解。

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