原发性中枢神经系统非霍奇金淋巴瘤临床分析
| 作者: |
1刘畅,
2许春伟,
3张立英,
4张岩
1 北京军区总医院肿瘤科，北京 100700 2 军事医学科学院附属医院病理科，北京 100071 3 北京军区总医院病理科，北京 100700 4 北京军区总医院附属八一脑科医院，北京 100700 |
| 通讯: |
刘畅
Email: bewilder2007@sina.com 许春伟 Email: xuchunweibbb@163.com |
| DOI: | 10.3978/j.issn.2095-6959.2016.07.004 |
摘要
目的：探讨原发性中枢神经系统非霍奇金淋巴瘤(primary central nervous system non-Hodgkin’s lymphoma，PCNSL) 的临床特征、治疗及预后。方法：回顾性分析4例原发性中枢神经系统淋巴瘤的临床资料和治疗疗效观察，并随访患者的复发率及生存情况。结果：4例原发性中枢神经系统淋巴瘤患者均为男性，发病年龄46~76岁，中位58.75岁。病灶分别位于脑干双侧丘脑低节、右侧脑室、右侧枕叶、右侧小脑，以头痛引起的颅内高压为主要临床症状。4例患者均术后给予大剂量MTX(HD-MTX)为主的化疗+全脑放疗；随访3年，1例复发术后死亡，3例存活。结论：原发性中枢神经系统淋巴瘤多发于中老年男性，颅内高压为主要临床症状，B细胞亚型占绝对优势。HD-MTX联合全脑放射治疗原发性中枢神经系统淋巴瘤有效可行，可提高患者的远期生存率。
关键词：
原发性非霍奇金淋巴瘤
中枢神经系统
综合治疗
Clinic analyses of primary central nervous system non-Hodgkin’s lymphoma
CorrespondingAuthor: LIU Chang Email: bewilder2007@sina.com
DOI: 10.3978/j.issn.2095-6959.2016.07.004
Abstract
Objective: To investigate the clinical features, treatment and prognosis of primary central nervous system non-Hodgkin’s lymphoma (PCNSL). Methods: Retrospectively analysed clinical data and treatment of four cases of PCNSL. The survival and recurrence were observed. Results: Four cases of PCNSL patients were all males, aged 46 to 76 years, with a median age of 58.75 years. Lesions were located in the lower section of the brainstem bilateral thalamus, right ventricle, right occipital lobe, and right cerebellum, headache caused by intracranial hypertension is the main clinical symptoms. All 4 cases were given large doses of MTX-based chemotherapy plus whole brain radiotherapy after surgery; follow-up for 3 years, 1 patient died of recurrence after surgery, 3 patients survived. Conclusion: PCNSL occurs mainly in middle-aged men, intracranial hypertension is the main clinical symptom, and B cell subtype predominant. HD-MTX combined with whole brain radiation therapy is effective and feasible in the treatment of PCNSL and can improve the patient’s long-term survival.