Sheng Xixi, Xu Mingwei, Li Xia
Department of Neurology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Address: No. 79 Qing-Chun Road, Hangzhou, Zhejiang 310003, PR China.
Transl Neurosci. 2020 Feb 18;11:28-33. doi: 10.1515/tnsci-2020-0005. eCollection 2020.
Primary central nervous system lymphoma (PCNSL) is rare. And the symptoms of PCNSL are atypical, it is extremely easy to be misdiagnosed as other diseases. However, early treatment is crucial which is requesting early diagnosis. We report a case of a 47-year-old man who was initially diagnosed as neuromyelitis optica (NMO) on the basis of clinical findings, slightly high Aquaporin4 (AQP4) (1:10) and high signals of magnetic resonance imaging. Though his symptoms progressively improved after steroid pulse treatment, but worse when steroid was decreased to 40 mg per day. We considered the patient should be diagnosed as PCNSL. After the examination of magnetic resonance spectroscopy (MRS) and positron emission tomography (PET), the results indicated PCNSL was most possible. Therefore we gave him stereotactic biopsy of deep of supratentorial, which showed non-Hodgkin malignant B-cell lymphoma.
原发性中枢神经系统淋巴瘤（PCNSL）较为罕见。且PCNSL的症状不典型，极易被误诊为其他疾病。然而，早期治疗至关重要，这就要求早期诊断。我们报告一例47岁男性患者，该患者最初根据临床表现、水通道蛋白4（AQP4）轻度升高（1:10）以及磁共振成像高信号被诊断为视神经脊髓炎（NMO）。尽管其症状在类固醇脉冲治疗后逐渐改善，但当类固醇减至每日40毫克时症状恶化。我们考虑该患者应被诊断为PCNSL。经磁共振波谱（MRS）和正电子发射断层扫描（PET）检查，结果提示最可能为PCNSL。因此我们对其进行了幕上深部立体定向活检，结果显示为非霍奇金恶性B细胞淋巴瘤。
