Albakr Abdulrahman, Alhothali Wajda, Samghabadi Peyman, Maeda Lauren, Nagpal Seema, Ajlan Abdulrazag
Neurosurgery, University of Calgary/ Foothills Medical Center, Calgary, CAN.
Neurosurgery, King Saud University, Riyadh, SAU.
Cureus. 2018 Nov 30;10(11):e3660. doi: 10.7759/cureus.3660.
Chronic lymphocytic leukemia (CLL) is the most common type of leukemia that affects older adults in the Western world. Symptomatic nervous system invasion in undiagnosed CLL is rare, poorly understood, challenging to treat, and associated with decreased survival. The average survival of CLL patients with central nervous system (CNS) involvement is 3.79 years as compared to six years in CLL patients without CNS involvement. Autopsy studies demonstrated a high incidence of undiagnosed CLL with CNS involvement, suggesting that CNS involvement is either underdiagnosed or subclinical. Although the most common site of CNS involvement is the leptomeninges, our case demonstrates an extremely rare form of CNS diffuse large B-cell parenchymal involvement in a patient with a concurrent diagnosis of systemic CLL.
慢性淋巴细胞白血病（CLL）是西方世界影响老年人的最常见白血病类型。未确诊的CLL出现症状性神经系统侵犯很罕见，了解甚少，治疗具有挑战性，且与生存率降低相关。中枢神经系统（CNS）受累的CLL患者的平均生存期为3.79年，而无CNS受累的CLL患者为6年。尸检研究表明，未确诊的CLL伴CNS受累的发生率很高，这表明CNS受累要么诊断不足，要么是亚临床的。虽然CNS受累最常见的部位是软脑膜，但我们的病例显示了一种极为罕见的CNS弥漫性大B细胞实质受累形式，该患者同时诊断为系统性CLL。
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