Gajaria Pooja Kamlesh, Shenoy Asha Sharad, Baste Balaji Devrao, Goel Naina Atul
Department of Pathology, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India.
Asian J Neurosurg. 2021 Feb 23;16(1):178-182. doi: 10.4103/ajns.AJNS_230_20. eCollection 2021 Jan-Mar.
Glioblastoma as second primary malignancy (SPM) has been reported after prostate cancer, meningiomas, Hodgkin's lymphoma. We report an extremely rare case of glioblastoma as SPM, occurring after remission of diffuse large B-cell lymphoma (DLBCL). Fifty-year-old male presented with loss of consciousness followed by right-sided weakness. He was treated with chemotherapy for DLBCL of the cervical lymph nodes, 5 years back. Present scans revealed well-defined intra-axial lesion in the left parietal lobe, suggestive of central nervous system (CNS) involvement by lymphoma. Left parieto-occipital craniotomy was performed and microscopic examination revealed the tumor to be Glioblastoma, WHO Grade IV. The tumor cells were positive for glial fibrillary acid protein and negative for leucocyte common antigen. He was treated by radiotherapy and temozolomide. Pathologic examination is a must for CNS lesions. Had it not been for the biopsy, the patient would have been treated as a recurrence of CNS lymphoma by chemotherapy and would have probably succumbed.
胶质母细胞瘤作为第二原发性恶性肿瘤（SPM）已在前列腺癌、脑膜瘤、霍奇金淋巴瘤之后被报道。我们报告了一例极为罕见的胶质母细胞瘤作为SPM的病例，发生在弥漫性大B细胞淋巴瘤（DLBCL）缓解之后。一名50岁男性出现意识丧失，随后出现右侧肢体无力。他5年前因颈部淋巴结的DLBCL接受了化疗。目前的扫描显示左顶叶有边界清晰的轴内病变，提示淋巴瘤累及中枢神经系统（CNS）。进行了左顶枕开颅手术，显微镜检查显示肿瘤为世界卫生组织IV级胶质母细胞瘤。肿瘤细胞胶质纤维酸性蛋白呈阳性，白细胞共同抗原呈阴性。他接受了放疗和替莫唑胺治疗。对于中枢神经系统病变，病理检查是必需的。如果没有活检，该患者可能会被当作中枢神经系统淋巴瘤复发而接受化疗，很可能会死亡。
