Iglesias-Rozas J R, Bantz B, Adler T, Jautzke G, Tosth U, Lange W, Stein H, Dienemann D
Neurochirurgical Clinic-Neuropathological Laboratory, Rudolf Virchow Hospital of Free University Berlin (Standort Wedding), Berlin, Germany.
Clin Neuropathol. 1991 Mar-Apr;10(2):65-72.
Neuropathological findings from 8 individual cases of cerebral lymphomas in AIDS patients with consideration of the clinical, radiological, immunopathological, and other pertinent data selected from a series of 80 patients between 1985 and 1989 were studied. A wide variation in pathology was noted among our cases. It has been shown that lymphoma as a neuropathological diagnosis can coexist with a wide range of other characteristics, including toxoplasmosis, glial nodules, neuronophagia, degeneration, bleeding, hypoxia, progressive multifocal leucoencephalopathy, and myelopathy, although none of these attributes appeared more than casually interrelated. In general, the late-stage manifestations of lymphoma as were observed in this study, tended to be poorly localized, often simultaneously meningeal, perivascular, and diffuse in character. An important distinction between cerebral lymphomas of AIDS and non-AIDS patients is the highly atypical, clinically unreliable computer tomographic signals observed in several of our cases. Five of the six immunopathological investigations showed a preponderance of B-cell markers, corresponding in toto to high-grade non-Hodgkin lymphoma. One case exhibited immunohistological markers typical of Hodgkin's lymphoma (antibody CD-30). Of 6 obtainable serum specimens from our 8 cases, 4 showed high (greater than 2000) IgG titers against the EBNA-1 antigen of Epstein-Barr virus (EBV), of these three had IgM titers further supporting viral reactivation. One showed a normal IgG titer, yet with a significantly raised IgM titer.
对1985年至1989年间从80例患者中选取的8例艾滋病患者脑淋巴瘤的神经病理学发现，并结合临床、放射学、免疫病理学及其他相关数据进行了研究。我们的病例中病理表现差异很大。研究表明，作为神经病理学诊断的淋巴瘤可与多种其他特征并存，包括弓形虫病、胶质结节、噬神经细胞现象、变性、出血、缺氧、进行性多灶性白质脑病和脊髓病，尽管这些特征之间似乎只是偶然相关。总体而言，本研究中观察到的淋巴瘤晚期表现往往定位不清，通常同时累及脑膜、血管周围且呈弥漫性。艾滋病患者与非艾滋病患者脑淋巴瘤的一个重要区别在于，我们的部分病例中观察到高度非典型、临床诊断不可靠的计算机断层扫描信号。六项免疫病理学检查中有五项显示B细胞标志物占优势，总体上与高级别非霍奇金淋巴瘤相符。一例表现出霍奇金淋巴瘤典型的免疫组织学标志物（抗体CD - 30）。在我们8例患者可获取的6份血清标本中，4份针对EB病毒（EBV）的EBNA - 1抗原显示高IgG滴度（大于2000），其中3份IgM滴度进一步支持病毒再激活。1份显示IgG滴度正常，但IgM滴度显著升高。
