Zhonghua wai ke za zhi [Chinese journal of surgery] · 2007
[Investigation of diagnosis and treatment for primary central nervous system lymphoma].
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Meng Fan-gang, Zhang Kai, Mao Geng-sheng, Wang Zhong-cheng, Wu Cheng-yuan, Liu Kui
Аннотация
OBJECTIVE: To investigate the clinical characteristics of primary central nervous system lymphoma (PCNSL) so as to improve comprehension of that unusual lesions.
METHODS: Forty-three cases of immunocompetent patients with a confirmed diagnosis of PCNSL were retrospectively reviewed. The clinical presentation, laboratory examination, imaging characteristics, histopathologic types and treatment were analyzed.
RESULTS: Single-locus lesion was found in thirty-six patients and multi-locus lesions were found in seven patients. Forty-seven operations were performed. The main characteristics including increased intracranial pressure in 22 cases (51.2%) followed by hemiparesis, seizure and speech problems in 16 cases (37.2%), disturbance of intellectual function and mental confusion in 10 cases (23.3%), contents of cerebrospinal fluid protein concentrations increased in 8 of 12 tested cases (66.7%). Histopathologic exam showed B-cell lymphoma in 40 (40/41, 97.6%) and T-cell lymphoma in 1 case (1/41, 2.4%). Ki-67 positive expression is 42.8% +/- 23.3% in 3 samples.
CONCLUSIONS: CT, MRI and CSF cytological examination are mainly diagnostic methods for PCNSL. Elevated lymphocyte counting in peripheral blood can not be the diagnostic criteria for PCNSL. The purpose of operation is alleviating symptom, increasing quantity of life and making histopathologic diagnosis. Adjuvant chemotherapy plus whole-brain radiation is an efficient treatment for PCNSL.
METHODS: Forty-three cases of immunocompetent patients with a confirmed diagnosis of PCNSL were retrospectively reviewed. The clinical presentation, laboratory examination, imaging characteristics, histopathologic types and treatment were analyzed.
RESULTS: Single-locus lesion was found in thirty-six patients and multi-locus lesions were found in seven patients. Forty-seven operations were performed. The main characteristics including increased intracranial pressure in 22 cases (51.2%) followed by hemiparesis, seizure and speech problems in 16 cases (37.2%), disturbance of intellectual function and mental confusion in 10 cases (23.3%), contents of cerebrospinal fluid protein concentrations increased in 8 of 12 tested cases (66.7%). Histopathologic exam showed B-cell lymphoma in 40 (40/41, 97.6%) and T-cell lymphoma in 1 case (1/41, 2.4%). Ki-67 positive expression is 42.8% +/- 23.3% in 3 samples.
CONCLUSIONS: CT, MRI and CSF cytological examination are mainly diagnostic methods for PCNSL. Elevated lymphocyte counting in peripheral blood can not be the diagnostic criteria for PCNSL. The purpose of operation is alleviating symptom, increasing quantity of life and making histopathologic diagnosis. Adjuvant chemotherapy plus whole-brain radiation is an efficient treatment for PCNSL.