Nedelcheva E, Popova L, Khadzhiev E
Vutr Boles. 1988;27(4):58-61.
For a five year period 235 patients with a malignant lymphoma were studied in clinical conditions. In 20 of them (8.9%) the central nervous system was affected: 13 patients showed signs of spinal cord compression, 5 patients were with meningosis and 2 patients had cerebral infiltrations. The meningeal affection was found in patients presenting certain risk factors: young age, packages of lymph nodes localized retroperitoneally, lymphomas with a high degree of malignancy, extranodal localization. The patients with meningosis have a short longevity which implies meningeal prophylaxis in the risk groups. The spinal cord compression as a complication of the lymphoma does not determine the prognosis. The prognosis is related to the spread of the lymphoma. The knowledge of the early manifestations of these complications and the timely treatment lead to a favourable result. A very good therapeutic result can be achieved by the combined treatment--polychemotherapy and intrathecal administration of a cytostatic (cyclophosphamide and/or methotrexate).
在五年期间,对235例恶性淋巴瘤患者进行了临床研究。其中20例(8.9%)中枢神经系统受累:13例出现脊髓压迫症状,5例有脑膜病变,2例有脑浸润。脑膜病变见于有某些危险因素的患者:年轻、腹膜后淋巴结肿大、高度恶性淋巴瘤、结外定位。有脑膜病变的患者生存期短,这意味着对高危人群应进行脑膜预防。淋巴瘤并发脊髓压迫并不决定预后。预后与淋巴瘤的扩散有关。了解这些并发症的早期表现并及时治疗可取得良好效果。联合治疗——多药化疗和鞘内给予细胞抑制剂(环磷酰胺和/或甲氨蝶呤)可取得非常好的治疗效果。