Brooks Christopher Alan, Kehoe John David, Kerr Neal, Ziad Fouzia, Raunio Sami
Neurosurgery, Waikato Hospital, Hamilton, Waikato, New Zealand
Neurosurgery, Waikato Hospital, Hamilton, Waikato, New Zealand.
BMJ Case Rep. 2023 Mar 21;16(3):e254093. doi: 10.1136/bcr-2022-254093.
Lymphoma of a dural genesis is a distinct variant of primary central nervous system lymphoma and is rare. It putatively has a more benign clinical course. Cranial primary dural lymphoma is more often marginal zone B-cell lymphoma, whereas spinal primary dural lymphoma is most commonly diffuse large B-cell lymphoma.We report a male patient who presented with subacute progressive radiculopathy due to a compressive infiltrative lumbosacral spinal lesion. This was determined to be primary dural diffuse large B-cell lymphoma. The radiology, therapeutic considerations and differentiating biological characteristics of primary dural lymphoma, differ from other primary central nervous system lymphomas.Primary dural lymphoma is under-represented in the medical literature. It has unique clinical characteristics. The optimal treatment algorithm remains undefined, but there is some evidence suggesting a benefit of surgical cytoreductive therapy in the first instance, and low-dose radiotherapy may be an effective adjuvant therapy in addition to chemotherapeutic and immunotherapeutic agents.
硬脑膜起源的淋巴瘤是原发性中枢神经系统淋巴瘤的一种独特变体，较为罕见。据推测，其临床病程相对较为良性。颅内原发性硬脑膜淋巴瘤多为边缘区B细胞淋巴瘤，而脊柱原发性硬脑膜淋巴瘤最常见的是弥漫性大B细胞淋巴瘤。我们报告一名男性患者，因腰骶部压迫性浸润性脊髓病变出现亚急性进行性神经根病。经诊断为原发性硬脑膜弥漫性大B细胞淋巴瘤。原发性硬脑膜淋巴瘤的放射学表现、治疗考量及生物学鉴别特征与其他原发性中枢神经系统淋巴瘤不同。原发性硬脑膜淋巴瘤在医学文献中的报道较少。它具有独特的临床特征。最佳治疗方案尚未明确，但有证据表明，首先进行手术细胞减灭治疗可能有益，除化疗和免疫治疗药物外，低剂量放疗可能是一种有效的辅助治疗方法。
