原发性中枢神经系统淋巴瘤35例临床分析

目的 探讨原发性中枢神经系统淋巴瘤的临床特点、诊断及治疗方法。方法 回顾性分析35例原发性中枢神经系统淋巴瘤的临床资料、病理特征及术前诊断方法。结果 本组男19例，女16例，男女比例为1．2：1。年龄26～72岁，平均年龄52岁。所有患者人免疫缺陷病毒(HIV)检查均为阴性。临床症状主要表现为颅内压增高、肢体无力、瘫痪和神经精神症状。57％的患者病史短于4周，发病急，病情进展快。肿瘤多位于额部、颚顶部和基底节区，本组共35例52个肿瘤，其中16例为多发性肿瘤(45．7％)。结论 原发性中枢神经系统淋巴瘤是一组异质性肿瘤，侵袭性大。病史短，发病急，病情进展快，常发生于幕上大脑半球，易多发，术前诊断困难．预后差．

Clinical features of primary central nervous system lymphoma

Objective To explore the clinical characteristics and diagnosis of primary central nervous system lymphoma(PCNSL). Methods Clinicopathologic features of 35 surgical patients with histologically proven PCNSL were studied. Results Patients included 19 male and 16 female whose median age at diagnosis was 52 years(range 26 to 72 years).The duration of symptoms was less than 4 weeks in 57% of the patients. Symptoms included increased intracranial pressure, arm and leg weakness or palsy, neuropsychiatric symptoms,and focal neurological deficit. A total of 52 tumors were seen in 35 patients: the most common sites were frontal(14 patients), temporoparietal(7 patients),and basal ganglia(5 patients); multiple lesions were in 16 patients. No patient had antecedent of human immunodeficiency virus positivity or acquired immunodeficiency syndrome. Surgical resection was performed in 32 of the cases, with the remainder undergoing biopsy only. Conclusion Primary central nervous system lymphoma is an aggressive lymphoma which shows cytologic variability from case to case.Acute onset presents with poor prognosis.