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目的总结原发性中枢神经系统淋巴瘤(PCNSL)的临床、影像学特征,提高PCNSL诊治水平。方法回顾性分析经立体定向活检病理证实的118例PCNSL的临床和影像学资料。结果 118例PCNSL患者的病理类型均为B细胞性,其中男性73例,女性45例,男:女=1.62∶1,患者年龄11～83岁(平均53.4±15.9岁)。首发症状到确诊的时间为7d～3年(3.47±6.65个月),病程在3个月以内的占78.75%,其中57.5%的患者病程在1个月以内。本组病例最常见的症状包括高颅压症状(51.1%)和肢体功能障碍(47.7%)。单发病灶63例(53.4%),多发病灶55例(46.6%),基底节区和丘脑是最常见的受累部位。CT检查病灶多为稍高密度影,MRI检查病灶多为长T1、等或长T2信号影,多数病灶增强扫描为片状均匀强化。结论 PCNSL多发于中老年人,男性多见,病程短,单发病灶多见,但多发病灶的比例也较高,影像学检查病灶多均匀强化,病灶边界不清,但缺乏特异性,确诊需依赖于立体定向活检病理诊断。
Objective To summarize the clinical and imaging features of primary central nervous system lymphoma (PCNSL) and to improve the diagnosis and treatment of PCNSL. Methods The clinical and imaging data of 118 PCNSL patients confirmed by stereotactic biopsy were retrospectively analyzed. Results The pathological types of 118 patients with PCNSL were all B cells. There were 73 males and 45 females with a male: 1.62: 1 ratio and a mean age of 53.4 ± 15.9 years. The first symptom to the time of diagnosis was 7d ~ 3 years (3.47 ± 6.65 months), the course of disease within 3 months accounted for 78.75%, of which 57.5% of patients within 1 month duration. The most common symptoms of this group of patients included symptoms of high intracranial pressure (51.1%) and limb dysfunction (47.7%). 63 cases (53.4%) had single lesion and 55 cases (46.6%) had multiple lesion. The basal ganglia and thalamus were the most common sites involved. CT lesions were mostly slightly higher density, MRI lesions were mostly long T1, etc. or long T2 signal shadow, most of the lesion enhancement scan for uniform sheet-like enhancement. Conclusions PCNSL is more common in the middle-aged and elderly. There are many males, short course of disease, more common single lesions, higher incidence of multiple lesions, more uniform imaging lesions, unclear border, but lack of specificity. Dependent on stereotactic biopsy pathological diagnosis.