[系统性红斑狼疮患者淋巴细胞性脑膜炎并发中枢神经系统淋巴瘤：一种罕见的关联]
[Central nervous system lymphoma revealed by lymphocytic meningitis in a patient with systemic lupus erythematosus: An unusual association].
作者信息
Roriz M, Lopes A, Jarrin I, Lechtman S, Polivka M, Bergmann J-F, Sène D, Mouly S
机构信息
Département de médecine interne, hôpital Fernand-Widal, groupe hospitalier Lariboisière, AP-HP, 2, rue Ambroise-Paré, 75475 Paris cedex 10, France; UMR-S1144, UFR de médecine Paris-Diderot, 10, avenue de Verdun, 75010 Paris, France.
Département de médecine interne, hôpital Fernand-Widal, groupe hospitalier Lariboisière, AP-HP, 2, rue Ambroise-Paré, 75475 Paris cedex 10, France.
出版信息
Rev Med Interne. 2017 Apr;38(4):269-273. doi: 10.1016/j.revmed.2016.05.019. Epub 2016 Jun 27.
INTRODUCTION
We report an unusual observation of central nervous system (CNS) lymphoma in a 60-year-old woman with systemic lupus erythematosus and fatal outcome.
OBSERVATION
The patient had systemic erythematosus lupus for 7 years, treated with mycophenolate mofetil and developed lymphocytic meningitis in 2015 associated to the presence of EBV in the cerebrospinal fluid and a necrotic vermis' lesion. Diagnosis of large B-cell lymphoma was histologically confirmed from stereotaxic biopsy, shortly before she died from neurological complications.
CONCLUSION
Even though the current association is unusual, lymphocytic meningitis with hypoglycorrachia in patients with systemic lupus erythematosus may reveal CNS lymphoma and diagnosis confirmation requires stereotaxic biopsy in order not to delay specific therapeutic management.
引言
我们报告了一例60岁患有系统性红斑狼疮的女性中枢神经系统（CNS）淋巴瘤的罕见病例，该病例预后不良。
观察
该患者患有系统性红斑狼疮7年，一直使用霉酚酸酯治疗，2015年出现淋巴细胞性脑膜炎，脑脊液中检测到EBV且伴有小脑蚓部坏死性病变。在她死于神经并发症前不久，立体定向活检组织学确诊为大B细胞淋巴瘤。
结论
尽管目前这种关联并不常见，但系统性红斑狼疮患者出现伴有脑脊液低糖的淋巴细胞性脑膜炎可能提示中枢神经系统淋巴瘤，确诊需要进行立体定向活检，以免延误特异性治疗。
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