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[中枢神经系统受累的非霍奇金恶性淋巴瘤——附7例报告]

[Non-Hodgkin's malignant lymphoma with central nervous involvement--report of 7 cases].

作者信息

Nagata T, Kobayashi A, Aiba K, Yokoyama K, Ikeda K, Kobayashi T, Chiene T, Kuraishi Y, Meguro S, Ichiba K, Abe M

出版信息

Gan No Rinsho. 1983 Jun;29(7):838-42.

PMID:6876452
Abstract

We encountered 7 non-Hodgkin's lymphomas involving the central nervous system (CNS) among 78 cases of lymphomas seen at the 3rd Dept. of Internal Med. between 1965 and 1980; 5 cases were diffuse histiocytic lymphomas (DH) and 2 were diffuse poorly differentiated lymphomas (DPDL). The age ranged from 27 to 66 years, there were 6 males and 1 female. In 4 cases, CNS involvement was the presenting symptom at the time of diagnosis of lymphoma. The diagnostic procedures in CNS lymphoma included complete neurological physical examination by a neurologist, spinal fluid cytology, surface marker study on lymphocytes of spinal fluid, if possible, computed tomography scan, and myelogram if spinal cord compression was suspected. The prognosis of patients with CNS involvement by lymphoma was poor even if early diagnosis was made. The conventional therapy for CNS lymphoma included cranial irradiation, systemic chemotherapy, and intrathecal instillation of methotrexate and/or cytosine arabinoside, or a combined modality; however, these treatments were only effective temporarily.

摘要

1965年至1980年间,在内科第三病房所见的78例淋巴瘤中,我们遇到了7例累及中枢神经系统(CNS)的非霍奇金淋巴瘤;5例为弥漫性组织细胞淋巴瘤(DH),2例为弥漫性低分化淋巴瘤(DPDL)。年龄范围为27至66岁,男性6例,女性1例。4例中,CNS受累是淋巴瘤诊断时的首发症状。CNS淋巴瘤的诊断程序包括由神经科医生进行全面的神经系统体格检查、脑脊液细胞学检查、脑脊液淋巴细胞表面标志物研究(如有可能)、计算机断层扫描,以及在怀疑脊髓受压时进行脊髓造影。即使早期诊断,淋巴瘤累及CNS的患者预后也很差。CNS淋巴瘤的传统治疗包括头颅放疗、全身化疗、鞘内注射甲氨蝶呤和/或阿糖胞苷,或联合治疗;然而,这些治疗仅暂时有效。

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