Seewann H L, Tilz G P, Becker H, Lehnert M
Dtsch Med Wochenschr. 1982 Nov 19;107(46):1763-6. doi: 10.1055/s-2008-1070203.
Laminectomy was performed in a 54-year-old patient who had a hemicauda syndrome. An epidural tumour, extending into the spongiosa of the third lumbar vertebra was found. Histologically it was a lymphoplasmacytoid lymphoma. Subsequent haematological investigation revealed a multilocular involvement (stage IV) and paraproteinaemia of the IgD-kappa-type. There was no Bence-Jones protein in the urine. After irradiation of the affected lumbar vertebra the patient was treated with a combination of chlorambucil and prednisone, later on with COP and VMCP regimens. A rapid downhill course set in 16 months after diagnosis and the patient died from intracerebral expansion of the immunocytoma. The clinical diagnosis was confirmed at autopsy. The generalized lymphoplasmacytoid immunocytoma contained evidence of terminal transformation into the polymorph subtype.
对一名患有半侧马尾综合征的54岁患者实施了椎板切除术。发现一个硬膜外肿瘤，延伸至第三腰椎的松质骨。组织学检查显示为淋巴浆细胞样淋巴瘤。随后的血液学检查发现有多部位受累（IV期）以及IgD-κ型副蛋白血症。尿液中未检测到本周蛋白。对受累腰椎进行放疗后，患者接受了苯丁酸氮芥和泼尼松联合治疗，后来采用COP和VMCP方案。诊断后16个月病情迅速恶化，患者死于免疫细胞瘤的脑内扩展。尸检证实了临床诊断。全身性淋巴浆细胞样免疫细胞瘤有向多形亚型终末转化的证据。
