Hrudková M, Belada D, Smolej L, Zák P, Malý J
Oddelení klinické hematologie II. interní kliniky Lékarské fakulty UK a FN Hradec Králové.
Vnitr Lek. 2010 Aug;56(8):795-800.
Primary central nervous system lymphoma (PCNSL) is a rare form of extranodal lymphoma (nearly always non-Hodgkin's) and accounts for approximately 3 to 4% of primary brain tumors. PCNSL typically affects patients older than 60 years. Clinical features are variable and reflect the location of central nervous system lesion. Magnetic resonance imaging and stereotactic biopsy are the most important tools for diagnostic assessment. Chemotherapy based on high-dose of methotrexate (HD-MTX) and whole brain radiotherapy are the cornerstones of treatment. Radiotherapy is usually omitted in individuals older than 60 years because of high risk of unacceptable delayed neurotoxicity. Treatment of PCNSL should be started as soon as possible after diagnosis because delay in treatment may shorten the patients' survival.
原发性中枢神经系统淋巴瘤(PCNSL)是一种罕见的结外淋巴瘤(几乎均为非霍奇金淋巴瘤),约占原发性脑肿瘤的3%至4%。PCNSL通常影响60岁以上的患者。临床特征多变,反映中枢神经系统病变的部位。磁共振成像和立体定向活检是诊断评估的最重要工具。基于大剂量甲氨蝶呤(HD-MTX)的化疗和全脑放疗是治疗的基石。由于存在不可接受的延迟神经毒性的高风险,60岁以上的患者通常不进行放疗。PCNSL的治疗应在诊断后尽快开始,因为治疗延迟可能会缩短患者的生存期。