Sun Jing, Ma Xiao-Shan, Qu Li-Mei, Song Xue-Song
Department of Anesthesiology, The First Hospital of Jilin University, Changchun 130021, Jilin Province, China.
Department of Neurosurgery, The First Hospital of Jilin University, Changchun 130021, Jilin Province, China.
World J Clin Cases. 2021 Mar 16;9(8):1885-1892. doi: 10.12998/wjcc.v9.i8.1885.
Subcutaneous panniculitis-like T-cell lymphoma (SPTCL) involvement in the central nervous system (CNS) is particularly rare. SPTCL with CNS involvement has an exceedingly poor prognosis, and no optimum therapeutic method has been discovered. To the best of our knowledge, this is the first reported case of SPTCL invading the CNS achieving long-term remission with lenalidomide maintenance therapy.
A 63-year-old man diagnosed with SPTCL was admitted to the hospital with severe headache for 15 d after four cycles of chemotherapy. Subsequent to the treatment, the patient developed CNS involvement. Craniotomy biopsy was pathologically diagnosed as CNS T-cell lymphoma, and two courses of chemotherapy were performed postoperatively. Due to the intolerance of the side effects of chemotherapeutic drugs, the patient received lenalidomide instead. The magnetic resonance imaging of the head at the 8 mo follow-up indicated no signs of recurrence, and the vital signs were stable.
Lenalidomide deserves further investigation as a targeted drug for SPTCL cases involving the CNS.
皮下脂膜炎样T细胞淋巴瘤(SPTCL)累及中枢神经系统(CNS)极为罕见。累及CNS的SPTCL预后极差,且尚未发现最佳治疗方法。据我们所知,这是首例报道的SPTCL侵犯CNS经来那度胺维持治疗实现长期缓解的病例。
一名63岁男性被诊断为SPTCL,在接受四个周期化疗后因严重头痛15天入院。治疗后,患者出现CNS受累。开颅活检病理诊断为CNS T细胞淋巴瘤,术后进行了两个疗程的化疗。由于患者对化疗药物副作用不耐受,改用了来那度胺。8个月随访时头部磁共振成像显示无复发迹象,生命体征稳定。
来那度胺作为治疗累及CNS的SPTCL的靶向药物值得进一步研究。