Brecher K, Hochberg F H, Louis D N, de la Monte S, Riskind P
Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA.
J Neurol Neurosurg Psychiatry. 1998 Dec;65(6):917-20. doi: 10.1136/jnnp.65.6.917.
A previously healthy 35 year old woman presented with bilateral uveitis associated with multiple, evolving, non-enhancing white matter lesions consistent with a progressive leukoencephalopathy such as multiple sclerosis. Thirty months after her initial presentation, she was diagnosed with primary CNS lymphoma and died 14 months later. The unusual clinical course preceding the diagnosis suggests that a demyelinating disease may have preceded, and possibly heralded, the development of primary CNS lymphoma. Cases of "sentinel lesions" heralding the diagnosis of primary CNS lymphoma have been reported, and this case further corroborates such instances and raises further issues regarding possible neoplastic transformation occurring in inflammatory diseases such as multiple sclerosis.
一名35岁既往健康的女性出现双侧葡萄膜炎，伴有多个不断演变的、无强化的白质病变，符合多发性硬化等进行性白质脑病的表现。在初次就诊30个月后，她被诊断为原发性中枢神经系统淋巴瘤，并于14个月后死亡。诊断前不寻常的临床病程提示，脱髓鞘疾病可能先于原发性中枢神经系统淋巴瘤出现，并可能是其先兆。已有报道“哨兵病变”预示原发性中枢神经系统淋巴瘤诊断的病例，本病例进一步证实了此类情况，并引发了关于在多发性硬化等炎症性疾病中可能发生肿瘤转化的更多问题。
