19例原发性中枢神经系统淋巴瘤误诊分析

目的分析原发性中枢神经系统淋巴瘤临床特点及误诊的原因。方法对19例被手术、术后病理和免疫组化证实的原发性中枢神经系统淋巴瘤进行回顾性分析。结果术前均误诊，其中误诊为胶质瘤8例，转移瘤4例，脑膜瘤5例，脱髓鞘疾病2例。根据术后病理及免疫组化结果，B细胞淋巴瘤18例，T细胞淋巴瘤仅1例。结论临床表现无特异性，术前误诊率高，CT和MRI表现有一定特点，确诊依靠病理检查。脑活组织病理检查是确诊的惟一手段。

Clinical analysis of the cause of misdiagnosis in 19 patients with primary central nervous system lymphoma

Objective To investigate the clinical features of primary central nervous system lymphoma （PCNSL） and its cause of misdiagnosis. Methods The date of 19 patients with PCNSL, which were confirmed by the operation and pathological and immunohistochemical examinations, were clinically analyzed retrospectively. Results All cases were misdiagnosed preoperatively. Of the misdiagnosed, 8 were diagnosed as neurospongioma, 4 as brain metastatic tumor, 5 as meningothelioma , and 2 as demydinating disease. According to the pathological and the immunohistochemical examinations, 18 cases were B-cell lymphoma, only 1 case was T-cell lymphoma. Conclusion There are no specific clinical manifestations of PCNSL and the disease is often misdiagnosed preoperatively. Although certain characteristic performance may be found on CT and MRI scans, the final diagnosis of this disease depends on pathological examination. Comprehensive treatments may prolong the survival time of the patients. Brain biopsy with pathological examination may be the only reliable method to confirm the diagnosis.