Xue Kun, Zhang Anling, Yan Xu, Liu Shuyu, Chen Dawei
Department of Neurosurgery, The First Hospital of Jilin University, Changchun, Jilin, China.
Department of Stomatology, Jilin Province First Automobile Workshop General Hospital, Changchun, Jilin, China.
Medicine (Baltimore). 2025 Apr 25;104(17):e42321. doi: 10.1097/MD.0000000000042321.
Primary central nervous system Burkitt lymphoma (PCNSBL) is a rare and aggressive malignancy, particularly challenging to diagnose in immunocompetent individuals due to its nonspecific presentation.
A 38-year-old immunocompetent woman presented with a 1-week history of progressively severe headaches in the left frontotemporal region, without systemic symptoms or significant laboratory abnormalities.
Advanced magnetic resonance imaging revealed a nodular lesion in the left frontal area, initially diagnosed as meningioma. Postsurgical histopathological analysis confirmed the diagnosis of Burkitt lymphoma, characterized by diffuse infiltration of medium-sized lymphocytes, a high MIB1 proliferation index, and Myc gene rearrangement.
The patient underwent complete surgical resection of the tumor and a 5-cycle chemotherapy regimen based on high-dose methotrexate, without the need for radiotherapy due to the localized nature of the tumor and complete surgical removal.
Postoperatively, the patient's headaches resolved, and no evidence of tumor recurrence was observed on magnetic resonance imaging after 11 months of follow-up. Additional examinations, including fluorodeoxyglucose-18-positron emission computed tomography, bone marrow biopsy, and cerebrospinal fluid cytology, confirmed the absence of systemic involvement.
This case highlights the importance of considering PCNSBL in the differential diagnosis of brain tumors, even in immunocompetent patients. Early diagnosis and a tailored chemotherapy regimen can lead to favorable treatment outcomes, emphasizing the need for a multimodality approach in managing PCNSBL.
原发性中枢神经系统伯基特淋巴瘤（PCNSBL）是一种罕见且侵袭性强的恶性肿瘤，由于其表现不具特异性，在免疫功能正常的个体中诊断颇具挑战。
一名38岁免疫功能正常的女性，有左侧额颞部进行性加重头痛1周病史，无全身症状或明显实验室异常。
增强磁共振成像显示左侧额叶有一个结节性病变，最初诊断为脑膜瘤。术后组织病理学分析确诊为伯基特淋巴瘤，其特征为中等大小淋巴细胞弥漫浸润、高MIB1增殖指数和Myc基因重排。
患者接受了肿瘤完整手术切除，并基于大剂量甲氨蝶呤进行了5个周期的化疗方案，由于肿瘤局限性及手术完整切除，无需放疗。
术后患者头痛缓解，随访11个月后磁共振成像未观察到肿瘤复发迹象。包括氟脱氧葡萄糖-18-正电子发射计算机断层扫描、骨髓活检和脑脊液细胞学检查在内的其他检查证实无全身受累。
该病例凸显了在脑肿瘤鉴别诊断中考虑PCNSBL的重要性，即使是在免疫功能正常的患者中。早期诊断和量身定制的化疗方案可带来良好的治疗效果，强调了在管理PCNSBL时采用多模式方法的必要性。
