DeAngelis L M
Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, NY.
J Neurooncol. 1990 Oct;9(2):177-81. doi: 10.1007/BF02427840.
Primary central nervous system lymphoma (PCNSL) can be confused with multiple sclerosis (MS) in patients who present with neurological dysfunction, a non-enhancing periventricular lesion, and CSF pleocytosis. Administration of corticosteroid causes clinical improvement and regression of PCNSL in some patients which may be interpreted as a steroid-induced remission from an exacerbation of MS. Sustained clinical dependence upon corticosteroid is unusual in MS, and should lead to consideration of PCNSL. Repeat CSF examination and gadolinium-enhanced MRI scan obtained off corticosteroid should differentiate between the two diagnostic possibilities.
原发性中枢神经系统淋巴瘤（PCNSL）在出现神经功能障碍、脑室周围无强化病变和脑脊液细胞增多的患者中可能与多发性硬化症（MS）相混淆。在一些患者中，使用皮质类固醇会使PCNSL出现临床改善和消退，这可能被解释为MS病情加重后由类固醇诱导的缓解。在MS中，持续临床依赖皮质类固醇的情况并不常见，这应促使考虑PCNSL。在停用皮质类固醇的情况下重复进行脑脊液检查和钆增强MRI扫描应能区分这两种诊断可能性。
