Yang J, Yuan G
Beijing Tiantan Hospital.
Zhonghua Wai Ke Za Zhi. 1996 Feb;34(2):102-3.
Primary intracranial malignant lymphoma is rate in clinic. But the incidence tends to be increasing recently. In its relatively short course, children and the slightly more woman headache vomiting IICP (increased intracranial pressure) and corresponding neurofunctional disorders due to various location of the tumors are the main clinical manifestation. Even high density which obviously increased after contrast and peripheral edema may be seen in CT scanning. MRI examination shows lowereal signals in T1 phase. But enhanced signals in T2 phase. Histologically the tumor mass is grayish in color often with a blussed borders (those located in brain surface often have rough borders) to the naked eye. Undermicroscope tumor cell may be seen around blood vessels with decreased cytosol, pathologic rayokinesis and somtimes focal hemorrhage necrosis. All patients in the 40 cases of our study group were connfirmed by surgical excision and patholog examination. Three patients died within half a year after resection. The others showed a survival period ranging from 4 to 20 months after postoperative irradiation solely or combined chemotherapy. Nine patients failed in total resection. Patients undergone postoperative irradiation but without following chemotherapy, only survived 4 to 9.7 months. Thus it can be seen that prolongation of the survival period of primary intracranial malignant lymphoma depends upon possibly early excision combined irradiation and effective chemotherapy.
原发性颅内恶性淋巴瘤在临床上较为少见。但近年来其发病率呈上升趋势。在其相对较短的病程中,儿童及女性略多,以头痛、呕吐等颅内压增高(IICP)症状以及因肿瘤位于不同部位而出现的相应神经功能障碍为主要临床表现。CT扫描可见高密度影,增强后明显强化,周边有水肿。MRI检查T1相呈低信号,T2相呈高信号。组织学上,肿瘤肉眼观呈灰白色,边界不清(位于脑表面者边界常粗糙)。显微镜下可见肿瘤细胞围绕血管,胞质减少,有病理核分裂,有时可见局灶性出血坏死。我们研究组的40例患者均经手术切除及病理检查确诊。3例患者术后半年内死亡。其余患者单纯术后放疗或联合化疗后生存期为4至20个月。9例患者未能全切。术后仅行放疗而未行后续化疗的患者,生存期仅4至9.7个月。由此可见,原发性颅内恶性淋巴瘤生存期的延长可能取决于尽早切除、联合放疗及有效的化疗。