Young R C, Howser D M, Anderson T, Fisher R I, Jaffe E, DeVita V T
Am J Med. 1979 Mar;66(3):435-43. doi: 10.1016/0002-9343(79)91065-9.
In 38 patients with non-Hodgkin's lymphoma, involvement of the central nervous system (CNS) by malignant lymphoma developed during an eight year period. All patients had lymphomatous meningitis; clinical involvement of the spinal nerves or cranial nerves suggested the diagnosis. Spinal fluid was abnormal in 97 per cent of the patients although a positive cytology could be documented in only 67 per cent by lumbar puncture. The histology in 82 per cent of the patients was diffuse. Involvement of the CNS in nodular lymphoma was uncommon (3 per cent), and the histology in virtually all of these patients had converted to diffuse. At the time of diagnosis of CNS disease, 95 per cent of the patients had other evidence of advanced disease; 66 per cent had bone marrow involvement. In only 18 per cent of the patients did CNS disease develop while they were in clinical remission. Eighty-five per cent of the patients treated with whole brain irradiation and intrathecal chemotherapy had a good clinical response. Knowledge of these risk factors permits definition of a group of patients who may benefit from CNS prophylaxis.
在38例非霍奇金淋巴瘤患者中，恶性淋巴瘤累及中枢神经系统（CNS）的情况在8年期间出现。所有患者均患有淋巴瘤性脑膜炎；脊神经或脑神经的临床受累提示了诊断。97%的患者脑脊液异常，尽管通过腰椎穿刺仅67%的患者可记录到阳性细胞学结果。82%患者的组织学类型为弥漫性。结节性淋巴瘤累及CNS的情况不常见（3%），并且几乎所有这些患者的组织学类型已转变为弥漫性。在诊断CNS疾病时，95%的患者有其他晚期疾病的证据；66%的患者有骨髓受累。仅18%的患者在临床缓解期出现CNS疾病。接受全脑照射和鞘内化疗的患者中，85%有良好的临床反应。了解这些危险因素有助于确定可能从CNS预防中获益的一组患者。
