中国肿瘤临床
中國腫瘤臨床
중국종류림상
CHINESE JOURNAL OF CLINICAL ONCOLOGY
2013年
22期
1400-1403
,共4页
中枢神经系统浸润%慢性淋巴细胞白血病诊断%治疗
中樞神經繫統浸潤%慢性淋巴細胞白血病診斷%治療
중추신경계통침윤%만성림파세포백혈병진단%치료
central nervous system infiltration%chronic lymphocytic leukemia diagnosis%treatment
目的：探讨慢性淋巴细胞白血病（chronic lymphocytic leukemia，CLL）伴中枢神经系统（central nervous system，CNS）浸润的发病率、诊治方法及预后。方法：报道1例以头晕、复视、肢体无力为首发表现的CLL患者诊治经过并结合文献复习。结果：尸解研究显示CLL浸润CNS的发生率为8%～71%，而患者生前出现有症状CNS浸润的发生率较低约1%，发生原因与临床分期、年龄、性别及疾病变异无明确相关性，临床表现不特异，诊断主要依靠脑脊液细胞形态学结合流式细胞分析，鞘内化疗及放疗可使多数患者CNS症状及脑脊液改善，未治疗的患者均迅速恶化死亡。结论：CLL有症状的CNS浸润较少见，一旦发生预后差，及时诊断和积极治疗是获得长期缓解的关键。
目的：探討慢性淋巴細胞白血病（chronic lymphocytic leukemia，CLL）伴中樞神經繫統（central nervous system，CNS）浸潤的髮病率、診治方法及預後。方法：報道1例以頭暈、複視、肢體無力為首髮錶現的CLL患者診治經過併結閤文獻複習。結果：尸解研究顯示CLL浸潤CNS的髮生率為8%～71%，而患者生前齣現有癥狀CNS浸潤的髮生率較低約1%，髮生原因與臨床分期、年齡、性彆及疾病變異無明確相關性，臨床錶現不特異，診斷主要依靠腦脊液細胞形態學結閤流式細胞分析，鞘內化療及放療可使多數患者CNS癥狀及腦脊液改善，未治療的患者均迅速噁化死亡。結論：CLL有癥狀的CNS浸潤較少見，一旦髮生預後差，及時診斷和積極治療是穫得長期緩解的關鍵。
목적：탐토만성림파세포백혈병（chronic lymphocytic leukemia，CLL）반중추신경계통（central nervous system，CNS）침윤적발병솔、진치방법급예후。방법：보도1례이두훈、복시、지체무력위수발표현적CLL환자진치경과병결합문헌복습。결과：시해연구현시CLL침윤CNS적발생솔위8%～71%，이환자생전출현유증상CNS침윤적발생솔교저약1%，발생원인여림상분기、년령、성별급질병변이무명학상관성，림상표현불특이，진단주요의고뇌척액세포형태학결합류식세포분석，초내화료급방료가사다수환자CNS증상급뇌척액개선，미치료적환자균신속악화사망。결론：CLL유증상적CNS침윤교소견，일단발생예후차，급시진단화적겁치료시획득장기완해적관건。
Objective:To explore the incidence, diagnosis, treatment, and prognosis of central nervous system (CNS) infiltration in chronic lymphocytic leukemia (CLL). Methods:One case with symptomatic CNS involvement reported dizziness, diplopia, and gen-eral fatigue as initial manifestations of CLL, as shown in a literature review. Results:Autopsy studies revealed that leukemic invasion of CNS was found in 8%to 71%of CLL patients, whereas incidence of leukemic infiltration in symptomatic CNS was approximately 1%. The complication did not correlate with any evident risk factors, and symptoms in patients with leukemic CNS infiltration were het-erogeneous and non-specific. Diagnosis of the disease depends on cerebrospinal fluid (CSF) cytology and flow cytometry. In most of similar cases, neurologic improvement is achieved by either intrathecal chemotherapy or radiation therapy. Failure to treat leukemic CNS infiltration leads to rapid deterioration and death. Conclusion:Leukemic involvement of the CNS is very rare in CLL cases and in-dicates poor prognosis. Prompt diagnosis and aggressive treatment are crucial for long-term remission and complete resolution of neuro-logical symptoms.
