Ramos Rui, Fernandes João Soares, Almeida Marta, Almeida Rui
Departamento de Neurocirurgia. Hospital de Braga. Braga. Portugal.
Departamento de Neurorradiologia. Hospital de Braga. Braga. Portugal.
Acta Med Port. 2018 Dec 28;31(12):777-783. doi: 10.20344/amp.10198.
Primary central nervous system lymphoma remission after steroid treatment is a well-known phenomenon, but remission without any type of treatment is extremely rare. We present a rare case of spontaneous remission of a diffuse large B-cell lymphoma of the central nervous system as well as its subsequent reappearance in another location. The atypical presentation misled the neurosurgeons and neurologists, delaying diagnosis and treatment. The patient underwent brain biopsy after the relapse and started radiotherapy and chemotherapy with cytarabine + methotrexate + rituximab. As of 32 months after the diagnosis, the patient remained asymptomatic, with no focal neurological deficits and the disease in complete remission. A PubMed search of the literature up to June 2017 regarding spontaneous remission central nervous system lymphoma was also carried out.
原发性中枢神经系统淋巴瘤经类固醇治疗后缓解是一种众所周知的现象,但未经任何类型治疗而缓解极为罕见。我们报告一例中枢神经系统弥漫性大B细胞淋巴瘤自发缓解以及随后在另一部位再次出现的罕见病例。非典型表现误导了神经外科医生和神经科医生,延误了诊断和治疗。患者复发后接受了脑活检,并开始使用阿糖胞苷+甲氨蝶呤+利妥昔单抗进行放疗和化疗。截至诊断后32个月,患者仍无症状,无局灶性神经功能缺损,疾病完全缓解。我们还对截至2017年6月的关于中枢神经系统淋巴瘤自发缓解的文献进行了PubMed检索。