原发性中枢神经系统淋巴瘤(附3例报道)

目的原发性中枢神经系统淋巴瘤很少见,本文报道3例原发性中枢神经系统淋巴瘤,以提高人们对本病的认识.方法回顾性分析3例患者的临床资料.结果2例患者临床以半身无力为主要症状,头颅CT、MRI检查示占位性病变,其中1例多发(3个病灶),1例单发.分别经脑活检和手术病理证实为淋巴瘤.1例患者首发症状为双侧视力障碍伴双下肢无力,经头颅CT、MRI检查未见异常,经脑脊液细胞学检查及免疫分型,诊断为淋巴细胞瘤.结论中枢神经系统淋巴瘤,特别是侵犯脑膜而非脑实质时,影像学检查有时也很难确诊,脑脊液细胞学检查为这些患者提供了可靠的临床诊断方法.

Primary leptomeningeal lymphoma:a report of 3 cases

Objective Primary lymphoma in the central nervous system is rare.In order to recognize it three cases of primary leptomeningeal lymphoma were presented in this article.Methods The clinic datas of three cases were analysed.Results Main abnormality firstly noticed was hemiplegia in 2 patients.CT and MRI showed some massive lesions.One of the patients had multiple lesions (three lesions) and the other one had only one lesion. The diagonosis was by brain biopsy and operation.The first sigh was blurred vision with weakness of both lower limbs in one patient.Brain CT and MRI were normal and the misdiagnosis was multiple sclerosis.At last the cytological and pathological studies for cerebral spinal fluid confirmed the diagnosis.Conclusions Diagnosis of primary lymphoma in the central nervous system is difficult even by the imagine studies, especially when the lesions are in meninges only, not in the parenchymal brain.The cytological analysis of cerebral spinal fluid is the reliable method for the clinical diagnosis.