原发性幕下弥漫性大B细胞淋巴瘤：免疫功能正常患者的一项具有挑战性的诊断。

Primary infratentorial diffuse large b-cell lymphoma: a challenging diagnosis in an immunocompetent patient.

作者信息

Beraldo Gabriel Laverdi, Brito Angelo Borsarelli Carvalho, Delamain Márcia Torresan, Souza Carmino Antonio de, Lima Carmen Silvia Passos, Bonfitto João Felipe Leite, Queiroz Luciano de Souza, Reis Fabiano

机构信息

Department of Radiology, Faculty of Medical Sciences, University of Campinas, Campinas, São Paulo, SP, Brasil.

Department of Internal Medicine, Faculty of Medical Sciences, University of Campinas, Campinas, São Paulo, SP, Brasil.

出版信息

Rev Assoc Med Bras (1992). 2019 Feb;65(2):136-140. doi: 10.1590/1806-9282.65.2.136.

DOI:10.1590/1806-9282.65.2.136

PMID:30892435

Abstract

We describe the case of a female patient, 52 years old, with dizziness and left motor incoordination for 2 weeks. Brain MRI magnetic resonance imaging) revealed a hyperintense lesion on T2-weighted images, without restricted diffusion, in the left middle cerebellar peduncle. Spectroscopy demonstrated peak of lipids and perfusion did not show any elevation in relative cerebral blood volume (rCBV). The patient underwent an open biopsy and resection, and the diagnosis of diffuse large B-cell lymphoma (DLBCL) was established. The patient received intravenous dexamethasone with symptoms remission, followed by four cycles of methotrexate plus cytarabine. After 3 months, the patient returned with decreased consciences level and a new MRI revealed a right superior frontal gyrus lesion with features suggesting a lymphomatous lesion. The patient died five days after her relapse.

摘要

我们描述了一名52岁女性患者的病例，该患者有2周的头晕和左侧运动不协调症状。脑部磁共振成像（MRI）显示在T2加权图像上左侧小脑中脚有一个高信号病变，无扩散受限。波谱分析显示脂质峰，灌注显示相对脑血容量（rCBV）无升高。患者接受了开放性活检和切除术，确诊为弥漫性大B细胞淋巴瘤（DLBCL）。患者接受静脉注射地塞米松后症状缓解，随后接受了四个周期的甲氨蝶呤加阿糖胞苷治疗。3个月后，患者因意识水平下降复诊，新的MRI显示右侧额上回有一个病变，特征提示为淋巴瘤病变。患者复发五天后死亡。