CAJ | 학술논문

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.
목적 동고의사염증성질병적신경계통비곽기금림파류병례,분석진단화치료과정,제고대해병적경척성.방법 본문회고료의사위염증성질병적3례신경계통비곽기금림파류병례적림상표현、뇌척액급영상학검사、병리학진、치료급예후.결과 신경계통비곽기금림파류가정만성파동성병정,영상학검사가무점위성효응,뇌척액검사무특정성표현,경격소치료후략유개선,인차역여신경계통염증건질병혼효.3례환자균수요통과병리활검학립진단,미급시화료,예후불가.결론 림상진료공작중유필요제고대중추신경계통림파류적경척성,주의병정적파동성、병조적불련관성、림상여영상적불일치성,이급기타계통시부수루,조기고필병리활검명학진단.
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.