原发性中枢神经系统淋巴瘤六例报告

目的：报道6例原发性中枢神经系统淋巴瘤（PCNSL）患者的临床资料，探讨这一少见病的临床特点、诊断及治疗。方法：对6例PCNSL患者的临床、影像、病理资料及治疗等进行全面分析。结果：免疫状态改变或病毒感染可能与发病有关。此病男性多见，中年为主，急性或亚急性起病，病程较短，进展较快，病态、体征多样，CT呈等密度或高密度，磁共振（MRI）呈长T1长T2，周围有水肿，有结节状或环状增强，组织学符合弥漫型B细胞型非霍奇金淋巴瘤（NHL），对糖皮质激素有一定治疗反应。其中3例生存期分别已达9、33、39个月，2例失访，1例死亡。结论：结合PCNSL临床表现、影像及病理学特点可对此病作出诊断，早期治疗有益预后。

Report of Primary Central Nervous System Lymphoma with Six Cases

Objective A series of 6 patients with primary central nervous system lymphoma (PCNSL)was reported, with clinical characteristics , diagnosis and treatment Methods The clinical data including clinical manifestations,radioimages,pathological findings and treatments were thoroughly analyzed. Results The changes of immunological status and virus infection might well be pathogenic to lymphoma production.In our hands,middle aged male preponderance was noted.The disease progressed rapidly with short duration.Sudden or subacute onset was always seen with variable symptom and signs.PCNSL on CT were either isodense or hyperdense with peritumor edema.High T1 and T2 weighted images were seen in MRI.The tumor was enhanced in nodular or ring like fasion. Therapeutic response to corticosteroids was dominant in some NHL cases. Histopathologically NHLs were mainly of diffused, B cell type. 3 cases were alive for 9,33,and 39 months respectively. Conclusions Diagnosis can be made according to clinical manifestation, neuroimage and pathology. Early treatment plays positive role in prognosis.