原发性中枢神经系统淋巴瘤29例临床分析

目的:原发性中枢神经系统淋巴瘤(PCNSL)是一种较少见的中枢神经系统恶性肿瘤。近年发病率有逐年增高的趋势,本文探讨PCNSL的临床、影像学表现、病理特征及治疗。方法:回顾性分析我院近10年来经手术及病理证实的29例PCNSL的临床、影像学表现、病理特征及治疗。结果:本组共29例(男性18例,女性11例,年龄8～72岁,病程15天～5个月)。本病以中老年人多见,发病急,病程短,病情进展快。CT扫描多表现为等密度肿块,MRI显示T1加权像多呈低信号,T2加权像多呈高信号,CT和MRI增强扫描病灶多呈均匀明显强化;肿瘤常发生于幕上,可单发或多发,极少发生出血、钙化或囊变;对放疗、化疗敏感。结论:PCNSL是一组异质性肿瘤,侵袭性强,预后差,其临床、影像学表现复杂多变,无特异性,术前诊断困难,确诊主要依靠病理检查。最佳治疗方案是手术加放疗、化疗的联合治疗。

Clinical analysis of primary central nervous system lymphoma(PCNSL)29 cases clinic report

Objective：PCNSL is a kind of rare central nervous system highly malignant tumor.There continues to be a significantly increasing incidence of PCNSL.To investigate the clinical,radiological and pathologic characteres of PCNSL.Methods：Twenty-nine cases with PCNSL depends on surgery and pathological examination were retrospectively analyzed in clinical and radiological findings and treatment.Results：There were tolally 29 cases in this paper（18 male and 11 female,8～72 years old and 15 days～5 months course）.This group of patients there were many characters of this disease such as short process,easly appearing in middle-old age,progressing in intracranial pressure increase rapidly and often occurring in supratentorial.It might be solitary or mutiple and invade ependyma and leptomeninges spreading itself along them.CT scanning showed the tumor had the same density as the brain.MRI indicated it was hypo-signal in T1WI and hyper-signal in T2WI.Enhanced scanning shows the lesion is contrasted evenly and obviously with rarely hemorrhage,calcification and cystic degeneration.it was sensitive to radiotherapy and chemotherapy.Conclusion：PCNSL is a group of heterogenicity tumor with strong invasion and poor prognosis.The imaging ieatures is complicated variable,no specificity.It is difficult to preoperative diagnosis only depending on their clinical and radiological characters.The diagnosis is determined by pathological examination.The best therapy includes operation,radiotherapy and chemotherapy.