Chen Xiaoli, Feng Jin, Zhang Weihua, Min Zhiqian, Zhao Shuqi
Department of Neurology, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi 710000, P.R. China.
Department of Clinical Laboratory Diagnostics, Xi'an Medical University, Xi'an, Shaanxi 710068, P.R. China.
Oncol Lett. 2024 Dec 31;29(3):113. doi: 10.3892/ol.2024.14859. eCollection 2025 Mar.
Primary central nervous system (CNS) lymphoma of the meninges is a rare tumor that originates in the meninges and does not show parenchymal or systemic spread. CNS involvement by natural killer (NK)/T-cell lymphoma accounts for only 2% of all extranodal NK/T-cell lymphomas, and primary NK/T-cell lymphoma of the meninges is even rarer. The present study reports a case of a 55-year-old male patient with primary NK/T-cell lymphoma. The patient presented with intermittent dizziness and headaches for the past 1 month prior to presentation. Magnetic resonance imaging of the head identified no overt abnormalities. However, cytological analysis of a Wright-Giemsa-stained cerebrospinal fluid (CSF) sample, demonstrated numerous atypical lymphocytes and lymphoma cells. Flow cytometry of the CSF was performed as an auxiliary method, and it showed that a large proportion of the cells in the CSF were of the NK/T-cell lineage, to indicating a diagnosis of NK/T-cell lymphoma. Mutations of 14 genes were detected, including JAK3 mutations, upon screening of the CSF for blood system diseases using next-generation sequencing. Therefore, the present study demonstrated that a CSF cytological examination may be an important component of the diagnostic workup for patients suspected to have a primary meningeal CNS lymphoma.
原发性中枢神经系统（CNS）脑膜淋巴瘤是一种罕见肿瘤，起源于脑膜，无实质或全身播散。自然杀伤（NK）/T细胞淋巴瘤累及中枢神经系统仅占所有结外NK/T细胞淋巴瘤的2%，而原发性脑膜NK/T细胞淋巴瘤更为罕见。本研究报告了一例55岁男性原发性NK/T细胞淋巴瘤患者。该患者在就诊前1个月出现间歇性头晕和头痛。头部磁共振成像未发现明显异常。然而，对瑞氏-吉姆萨染色的脑脊液（CSF）样本进行细胞学分析，发现大量非典型淋巴细胞和淋巴瘤细胞。作为辅助方法对脑脊液进行了流式细胞术检测，结果显示脑脊液中大部分细胞为NK/T细胞系，提示诊断为NK/T细胞淋巴瘤。使用下一代测序技术对脑脊液进行血液系统疾病筛查时检测到14个基因的突变，包括JAK3突变。因此，本研究表明脑脊液细胞学检查可能是疑似原发性脑膜中枢神经系统淋巴瘤患者诊断检查的重要组成部分。
