I期弥漫性大B细胞淋巴瘤病例中的孤立性中枢神经系统继发性复发。
Isolated secondary CNS relapse in a case of stage I diffuse large B-cell lymphoma.
作者信息
Najjar Yana G, Mittal Kriti, Faza Nadeen N, Dushkin Holly, Peereboom David M
机构信息
Department of Internal Medicine, The Cleveland Clinic Foundation, Cleveland, Ohio, USA.
出版信息
BMJ Case Rep. 2014 May 5;2014:bcr2013201442. doi: 10.1136/bcr-2013-201442.
A 55-year-old woman was admitted to our hospital with a 10-day history of right arm weakness and numbness. The patient's medical history was notable for lobular carcinoma in situ of the right breast in 2008 and stage I diffuse large B-cell lymphoma of the left axilla. The patient had completed treatment with chemotherapy and radiation 2 months prior to presentation. Blood counts, metabolic panel and lumbar puncture were unremarkable. MRI of the brain revealed multiple enhancing masses. The patient was started on dexamethasone, with rapid symptom improvement. A stereotactic brain biopsy revealed CD20 diffuse large B-cell lymphoma. The patient was started on high-dose intravenous methotrexate. She has received 11 cycles and has regained near normal function of the right arm. The patient's most recent brain MRI showed near complete resolution of all previously seen abnormal foci of enhancement.
一名55岁女性因右臂无力和麻木10天入住我院。患者既往病史包括2008年右乳小叶原位癌和左腋窝I期弥漫性大B细胞淋巴瘤。患者在就诊前2个月已完成化疗和放疗。血常规、代谢指标和腰椎穿刺均无异常。脑部MRI显示多个强化肿块。患者开始使用地塞米松治疗，症状迅速改善。立体定向脑活检显示为CD20弥漫性大B细胞淋巴瘤。患者开始接受大剂量静脉注射甲氨蝶呤治疗。她已接受11个周期的治疗，右臂功能已恢复至接近正常。患者最近的脑部MRI显示，所有先前可见的强化异常病灶几乎完全消退。
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