Boshrabadi Ahmad Pourrashidi, Naiem Ali, Ghazi Mirsaeid Seyed Shahab, Yarandi Kourosh Karimi, Amirjamshidi Abbas
Department of Neurosurgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Surg Neurol Int. 2017 Aug 1;8:165. doi: 10.4103/sni.sni_446_16. eCollection 2017.
The most common lymphoid malignancy in adults is diffuse large B-cell lymphoma (DLBCL). The median age of occurrence of DLBCL is between 6 and 7 decade of life, although some other types of aggressive non-Hodgkin's lymphomas (NHL) are present in younger age. Primary central nervous system lymphoma (PCNSL) is an uncommon type of extranodal NHL, which is either more prevalent or is diagnosed more often than before.
A 22-year-old man with ventriculoperitoneal shunt (VPS) performed at another center was referred with manifestations of shunt malfunction, unusual behavior, dysphasia, and hallucination. The shunt malfunction was handled appropriately several times and exploration of the enhancing cystic temporal lesion confirmed the diagnosis of DLBCL.
In this communication, we intend to highlight the issue that hydrocephalus refractory to several interventions can be the sole manifestation of PCNSL and needs special clinical considerations.
成人中最常见的淋巴系统恶性肿瘤是弥漫性大B细胞淋巴瘤(DLBCL)。DLBCL的发病中位年龄在6至7十岁之间,不过其他一些侵袭性非霍奇金淋巴瘤(NHL)在较年轻患者中也有出现。原发性中枢神经系统淋巴瘤(PCNSL)是一种罕见的结外NHL类型,其发病率比以往更高或诊断更为频繁。
一名22岁男性,曾在另一家中心接受脑室腹腔分流术(VPS),因分流功能障碍、行为异常、吞咽困难和幻觉等症状前来就诊。分流功能障碍多次得到妥善处理,对颞叶强化囊性病变的探查确诊为DLBCL。
在本报告中,我们旨在强调一个问题,即经多次干预仍难治的脑积水可能是PCNSL的唯一表现,需要特殊的临床考量。