Hu Rong, Zhang Rong, Miao Miao, Zhu Ke, Yang Wei, Liu Zhuogang
Department of Hematology, Shengjing Hospital, China Medical University, Shenyang, China.
Am J Case Rep. 2013 Aug 2;14:292-4. doi: 10.12659/AJCR.889308. Print 2013.
Female, 27 FINAL DIAGNOSIS: Central nervous system leukemia Symptoms: Abdominal mass • fever • nausea • vomitting
Unusual clinical course.
Primary lymphoma of urinary system is an uncommon entity including primary renal lymphoma, primary ureter lymphoma, bladder lymphoma, and urethra (including prostate) lymphoma. The pathology of PRL is usually diffuse large B-cell lymphoma.
In this study we describe a 27-year-old Chinese woman with central nervous system leukemia due to PRL. It was classified as diffuse large B-cell lymphoma non-GCB type according to kidney biopsy. We selected R-CHOP as a regimen and it showed good curative effect. However, the patient suffered recurrence involving the central nervous system with complaint of intolerable iliac-sacral pain at 26 days after 6 courses of R-CHOP.
This case shows that prognosis of PRL is poorer than nodal lymphoma. There is an urgent need for a more effective strategy with higher blood-brain barrier permeability.
女性，27岁 最终诊断：中枢神经系统白血病 症状：腹部肿块、发热、恶心、呕吐
不寻常的临床病程
原发性泌尿系统淋巴瘤是一种罕见疾病，包括原发性肾淋巴瘤、原发性输尿管淋巴瘤、膀胱淋巴瘤和尿道（包括前列腺）淋巴瘤。原发性肾淋巴瘤的病理通常为弥漫性大B细胞淋巴瘤。
在本研究中，我们描述了一名27岁的中国女性，因原发性肾淋巴瘤导致中枢神经系统白血病。根据肾活检，其被分类为非生发中心B细胞型弥漫性大B细胞淋巴瘤。我们选择R-CHOP方案，显示出良好的疗效。然而，该患者在接受6个疗程的R-CHOP治疗后26天复发，累及中枢神经系统，主诉骶髂部疼痛难忍。
该病例表明，原发性肾淋巴瘤的预后比淋巴结淋巴瘤更差。迫切需要一种具有更高血脑屏障通透性的更有效策略。
