Department of Neurosurgery, The Royal Melbourne Hospital, Victoria, Australia; Department of Surgery, The University of Melbourne, Victoria, Australia.
Department of Neurosurgery, The Royal Melbourne Hospital, Victoria, Australia; Department of Neurosurgery, University of Rochester Medical Center, Rochester, NY, USA.
J Clin Neurosci. 2019 Nov;69:269-272. doi: 10.1016/j.jocn.2019.08.053. Epub 2019 Aug 23.
Lymphomas affecting the central nervous system (CNS), both primarily and secondarily, are uncommon malignancies. Immunosuppressed states, including iatrogenic immunosuppression following organ transplantation, are the most significant risk factors for developing primary CNS lymphoma (PCNSL). Post-transplant lymphoproliferative disease (PTLD) is a well described complication following bone marrow or solid organ transplantation. PTLD is usually a systemic disease with occasional CNS involvement. The incidence of CNS involvement in PTLD is low, and the majority of these cases tend to be PCNSL. Hodgkin lymphoma PTLD (HL-PTLD) constitutes only a very small percentage of PTLD. We report a rare case of a primary intraventricular CNS classical HL-PTLD in a male patient, 18 years following renal transplantation. The location allowed for safe neurosurgical intervention which resolved the symptom of elevated intracranial pressure and allowed for induction of a Rituximab-based chemotherapy regimen. Both the ventricular location of the PTLD and Hodgkin Lymphoma PTLD are themselves individually quite rare and have not previously been reported together. The unique location allowed safe neurosurgical intervention which quickly resolved the symptom of elevated intracranial pressure and allowed for induction of a Rituximab-based chemotherapy regimen.
中枢神经系统（CNS）原发性和继发性淋巴瘤均为罕见的恶性肿瘤。免疫抑制状态，包括器官移植后的医源性免疫抑制，是发生原发性中枢神经系统淋巴瘤（PCNSL）的最重要危险因素。移植后淋巴组织增生性疾病（PTLD）是骨髓或实体器官移植后的一种明确并发症。PTLD 通常是一种全身性疾病，偶尔会累及 CNS。PTLD 累及 CNS 的发生率较低，其中大多数为 PCNSL。霍奇金淋巴瘤 PTLD（HL-PTLD）仅占 PTLD 的一小部分。我们报告了 18 例肾移植后男性患者发生罕见的原发性脑室中枢神经系统经典 HL-PTLD 的病例。由于该位置可以进行安全的神经外科干预，因此可以解决颅内压升高的症状，并可以诱导基于利妥昔单抗的化疗方案。PTLD 和霍奇金淋巴瘤 PTLD 的脑室位置均非常罕见，且以前从未一起报告过。该独特的位置可以进行安全的神经外科干预，迅速解决颅内压升高的症状，并可以诱导基于利妥昔单抗的化疗方案。
