疑似炎症性疾病的神经系统非霍奇金淋巴瘤

目的 同顾疑似炎症性疾病的神经系统非霍奇金淋巴瘤病例,分析诊断和治疗过程,提高对该病的警惕性.方法 本文回顾了疑似为炎症性疾病的3例神经系统非霍奇金淋巴瘤病例的临床表现、脑脊液及影像学检查、病理确诊、治疗及预后.结果 神经系统非霍奇金淋巴瘤可呈慢性波动性病程,影像学检查可无占位性效应,脑脊液检查无特征性表现,经激素治疗后略有改善,因此易与神经系统炎症件疾病混淆.3例患者均需要通过病理活检确立诊断,未及时化疗,预后不佳.结论 临床诊疗工作中有必要提高对中枢神经系统淋巴瘤的警惕性,注意病程的波动性、病灶的不连贯性、临床与影像的不一致性,以及其他系统是否受累,早期考虑病理活检明确诊断.

Clinical analysis of nervous system non-Hodgkin's lymphoma resembling to inflammatory diseases

Objective To characterize the manifestations of non-Hodgkin's lymphoma in nervous system with in-flammation-like presentation. Methods We reviewed clinical and laboratory data obtained from 3 cases of non-Hodgkin's lymphoma in nervous system with inflammation-like presentation.Those data include clinical manifestations,CSF examina-tions neuroimaging,pathology of biopsies,treatment and prognosis.Results The clinical manifestations of NHL in nervous system were variable and the findings of cerebrospinal fluid and imaging were not characteristic.Parital relief of symptoms by steroid cortisone could be achieved in some cases which maght further increased the difficulty in differentiating NHL from CNS inflammation.Several signs including no evidence of CNS inflammation,multiple organ involyements,especially the organ involvements outside CNS,and deterioration after a transient relief of symptoms by steroid cortisone,strongly suggest the possibility of NHL.Condusions We should increase physicians'awareness to NHL to reduce the misdiagnosis even though the final diagnosis relies on pathological examination.