原发性中枢神经系统恶性淋巴瘤27例临床病理分析

目的 :分析和探讨原发性中枢神经系统恶性淋巴瘤 (PCNSML)的临床与病理学特点。　方法 :总结经手术证实的 2 7例PCNSML患者的临床资料 ,并进行病理学及免疫组化研究 ;　结果 :患者以中年男性为多 ,临床表现无特异性 ,术前误诊率高。病理学显示 2 6例为B细胞淋巴瘤 ,绝大多数属弥漫性大B细胞淋巴瘤 ;1例为T细胞淋巴瘤。 81.3%B细胞淋巴瘤bcl 2呈阳性表达。术后行放、化疗者生存期优于单纯手术者。　结论 :PCNSML临床早期诊断困难 ,治疗方案应采取以手术加放化疗的综合治疗措施

Primary malignant lymphoma of the CNS: clinical and pathological analysis of 27 cases

Objectives:To find out and confirm the clinical and pathological features of primary CNS malignant lymphoma (PCNSML). Methods:Twenty seven cases of PCNSML, confirmed by pathological examination after operation, were collected for pathological and immunohistochemical study. Results:Most of the PCNSML cases were male. No characteristic clinical presentation was found and there was a high misdiagnosis rate before operation. Pathologically 26 cases were classified as centrocytic B cell lymphoma and one case was T cell lymphoma, 81.3%(13/16) of B cell lymphoma appeared positive for bcl 2. The patients treated with chemotherapy and/or radiotherapy after operation had more prolonged survival than those without chemotherapy and radiothrapy. Conclusions: The early diagnosis of PCNSML are generally difficult and a comprehensive treatment with chemotherapy and/or radiotherapy after operation is required for the treatment protocol for PCNSML.