Department of Pathology, China‑Japan Union Hospital, Jilin University, Changchun, Jilin 130033, P.R. China.
Department of Radiology, China‑Japan Union Hospital, Jilin University, Changchun, Jilin 130033, P.R. China.
Oncol Rep. 2023 Jan;49(1). doi: 10.3892/or.2022.8457. Epub 2022 Dec 9.
Primary central nervous system lymphoma (PCNSL) and high‑grade glioma (HGG) are distinct entities of the CNS with completely distinct treatments. The treatment of PCNSL is chemotherapy‑based, while surgery is the first choice for HGG. However, the clinical features of the two entities often overlap, and a clear pathological diagnosis is important for subsequent management, especially for the management of PCNSL. Stereotactic biopsy is recognized as one of the minimally invasive alternatives for evaluating the involvement of the CNS. However, in the case of limited tissue materials, the differential diagnosis between the two entities is still difficult. In addition, some patients are too ill to tolerate a needle biopsy. Therefore, combining imaging, histopathology and laboratory examinations is essential in order to make a clear diagnosis as soon as possible. The present study reviews the progress of comparative research on both imaging and laboratory tests based on the pathophysiological changes of the two entities, and proposes an integrative and optimized diagnostic process, with the purpose of building a better understanding for neurologists, hematologists, radiologists and pathologists.
原发性中枢神经系统淋巴瘤（PCNSL）和高级别胶质瘤（HGG）是中枢神经系统中两种截然不同的实体，治疗方法也完全不同。PCNSL 的治疗基于化疗，而手术则是 HGG 的首选治疗方法。然而，这两种实体的临床特征经常重叠，明确的病理诊断对后续管理很重要，特别是对 PCNSL 的管理。立体定向活检被认为是评估中枢神经系统受累的一种微创替代方法之一。然而，在组织材料有限的情况下，两种实体之间的鉴别诊断仍然很困难。此外，一些患者病得太重，无法耐受针吸活检。因此，结合影像学、组织病理学和实验室检查对于尽快做出明确诊断至关重要。本研究综述了基于两种实体的病理生理变化，对影像学和实验室检查比较研究的进展，并提出了一种综合优化的诊断流程，旨在为神经科医生、血液科医生、放射科医生和病理科医生提供更好的理解。
