Flinn I W, Ambinder R F
Johns Hopkins Oncology Center, Baltimore, MD 21231, USA.
Curr Opin Oncol. 1996 Sep;8(5):373-6. doi: 10.1097/00001622-199609000-00007.
The incidence of primary central nervous system lymphomas is increased several 1000-fold in AIDS patients. These are B-cell malignancies consistently associated with Epstein-Barr virus. They typically occur late in the course of HIV infection and are associated with a very short median survival. The pattern of Epstein-Barr virus gene expression is indicative of severe immunocompromise. Radiographic differentiation from toxoplasmosis remains a problem. Polymerase chain reaction amplification of Epstein-Barr virus DNA in cerebrospinal fluid, 18F-fluoro-deoxyglucose-positron emission tomography scanning, and 201-thallium single-photo emission CT are all promising noninvasive or minimally invasive diagnostic procedures that may obviate the need for brain biopsy in the future. Occasional patients have long remissions after therapy but most patients die within a few months. A possible role for combined modality therapy, including combination chemotherapy, is being explored.
原发性中枢神经系统淋巴瘤在艾滋病患者中的发病率增加了数千倍。这些是与爱泼斯坦-巴尔病毒始终相关的B细胞恶性肿瘤。它们通常发生在HIV感染病程的后期，且中位生存期非常短。爱泼斯坦-巴尔病毒基因表达模式表明存在严重免疫功能低下。与弓形虫病进行影像学鉴别仍然是一个问题。脑脊液中爱泼斯坦-巴尔病毒DNA的聚合酶链反应扩增、18F-氟脱氧葡萄糖正电子发射断层扫描以及201铊单光子发射CT都是很有前景的非侵入性或微创诊断程序，未来可能无需进行脑活检。偶尔有患者在治疗后有长期缓解，但大多数患者在几个月内死亡。正在探索包括联合化疗在内的综合治疗方法的可能作用。
