PDF(Pubmed)
Abstract：
BACKGROUND: Primary central nervous system lymphoma (PCNSL) is a rare, highly malignant form of non-Hodgkin lymphoma categorized under the diffuse large B-cell type. It accounts for merely 1% of all non-Hodgkin lymphoma cases and comprises approximately 3% of all brain tumors. The involvement of the cerebellum is observed in only 9% of these cases. Recently, we came across an unusual instance: a young man presenting with multiple lesions located specifically within the cerebellum.
METHODS: A 26-year-old male was admitted to the hospital due to severe headaches. He has a medical history of sporadic headaches, accompanied by dizziness, nausea, and vomiting persisting for a month. Over the last 10 days, his headaches have intensified, coupled with decreased vision and protrusion of the eyeballs. Magnetic resonance imaging (MRI) revealed abnormal signals in both cerebellar hemispheres.
METHODS: Diagnostic procedures included cerebellar biopsy, posterior fossa decompression, and lateral ventricle drainage. Histopathological examination identified diffuse large B-cell lymphoma (DLBCL) with high proliferative activity. To minimize neurotoxicity, chemotherapy involved intrathecal methotrexate (MTX) injections combined with the CHOP program. The patient has shown good tolerance to the treatment so far.
CONCLUSIONS: While the definitive optimal treatment approach remains elusive, current chemotherapy centered on high-dose MTX stands as the standard induction therapy. Integrating surgery with radiotherapy and chemotherapy significantly extends patient survival.
METHODS: A 26-year-old male was admitted to the hospital due to severe headaches. He has a medical history of sporadic headaches, accompanied by dizziness, nausea, and vomiting persisting for a month. Over the last 10 days, his headaches have intensified, coupled with decreased vision and protrusion of the eyeballs. Magnetic resonance imaging (MRI) revealed abnormal signals in both cerebellar hemispheres.
METHODS: Diagnostic procedures included cerebellar biopsy, posterior fossa decompression, and lateral ventricle drainage. Histopathological examination identified diffuse large B-cell lymphoma (DLBCL) with high proliferative activity. To minimize neurotoxicity, chemotherapy involved intrathecal methotrexate (MTX) injections combined with the CHOP program. The patient has shown good tolerance to the treatment so far.
CONCLUSIONS: While the definitive optimal treatment approach remains elusive, current chemotherapy centered on high-dose MTX stands as the standard induction therapy. Integrating surgery with radiotherapy and chemotherapy significantly extends patient survival.
摘要：
背景：原发性中枢神经系统淋巴瘤（PCNSL）是一种罕见的，非霍奇金淋巴瘤的高度恶性形式分类为弥漫性大B细胞型。它仅占所有非霍奇金淋巴瘤病例的1％，约占所有脑肿瘤的3％。仅在9％的这些病例中观察到小脑受累。最近,我们遇到了一个不寻常的例子：一个年轻人，表现出多个病变，特别位于小脑内。
方法：一名26岁男性因严重头痛入院。他有偶发性头痛的病史,伴有头晕,恶心,呕吐持续一个月。在过去的10天里，他的头痛加剧了，再加上视力下降和眼球突出。磁共振成像（MRI）显示两个小脑半球的异常信号。
方法：诊断程序包括小脑活检，后颅窝减压术,侧脑室引流.组织病理学检查发现弥漫性大B细胞淋巴瘤（DLBCL）具有高增殖活性。为了尽量减少神经毒性，化疗包括鞘内注射甲氨蝶呤(MTX)联合CHOP方案.到目前为止，患者对治疗表现出良好的耐受性。
结论：虽然最终的最佳治疗方法仍然难以捉摸，目前以大剂量MTX为中心的化疗是标准诱导疗法.将手术与放疗和化疗相结合可显着延长患者的生存期。
方法：一名26岁男性因严重头痛入院。他有偶发性头痛的病史,伴有头晕,恶心,呕吐持续一个月。在过去的10天里，他的头痛加剧了，再加上视力下降和眼球突出。磁共振成像（MRI）显示两个小脑半球的异常信号。
方法：诊断程序包括小脑活检，后颅窝减压术,侧脑室引流.组织病理学检查发现弥漫性大B细胞淋巴瘤（DLBCL）具有高增殖活性。为了尽量减少神经毒性，化疗包括鞘内注射甲氨蝶呤(MTX)联合CHOP方案.到目前为止，患者对治疗表现出良好的耐受性。
结论：虽然最终的最佳治疗方法仍然难以捉摸，目前以大剂量MTX为中心的化疗是标准诱导疗法.将手术与放疗和化疗相结合可显着延长患者的生存期。
