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C8神经根处酷似神经鞘瘤的弥漫性大B细胞淋巴瘤:病例说明

Diffuse large B-cell lymphoma in the C8 root mimicking a schwannoma: illustrative case.

作者信息

Ramirez-Velandia Felipe, Manchella Mohit K, Penumaka Anirudh, Schwartz Steven N, Varma Hemant, Vega Rafael A, Moses Ziev B

机构信息

Division of Neurosurgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.

Department of Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.

出版信息

J Neurosurg Case Lessons. 2024 Aug 19;8(8). doi: 10.3171/CASE24338.

Abstract

BACKGROUND

Primary lymphomas arising in peripheral nerves are extremely rare, with just a few case reports documented in the literature.

OBSERVATIONS

The authors present the case of a 62-year-old female with C8 radiculopathy, initially suspected to have a schwannoma based on imaging but later diagnosed with primary C8 nerve root B-cell lymphoma. Following histopathological confirmation, the patient underwent 5 courses of chemotherapy, resulting in a decrease in the size of her lesion on magnetic resonance imaging. At her clinical follow-up 3 months later, her symptoms had improved. After performing a systematic review of the literature while adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guidelines, the authors found only 3 similar cases, each with atypical presentations and treated with various chemotherapeutic agents and one of which experienced a central nervous system recurrence.

LESSONS

These cases highlight the importance of early and accurate diagnosis for optimal management and long-term vigilance of primary lymphomas in the peripheral nerve. https://thejns.org/doi/10.3171/CASE24338.

摘要

背景

起源于周围神经的原发性淋巴瘤极为罕见,文献中仅有少数病例报告。

观察结果

作者报告了一例62岁患有C8神经根病的女性病例,最初根据影像学怀疑为神经鞘瘤,但后来诊断为原发性C8神经根B细胞淋巴瘤。经组织病理学确诊后,患者接受了5个疗程的化疗,磁共振成像显示其病变大小减小。在3个月后的临床随访中,她的症状有所改善。作者在遵循系统评价和Meta分析的首选报告项目报告指南对文献进行系统回顾后,仅发现3例类似病例,每例均表现不典型,采用了各种化疗药物治疗,其中1例出现中枢神经系统复发。

经验教训

这些病例凸显了早期准确诊断对于原发性周围神经淋巴瘤最佳治疗及长期监测的重要性。https://thejns.org/doi/10.3171/CASE24338

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0e8e/11337938/a54d0e740cf7/CASE24338_figure_2.jpg

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