CAJ | 학술논문

目的探讨原发性中枢神经系统淋巴瘤(PCNSL)的诊治及误诊原因.方法回顾性分析经术后病理证实的19例PCNSL患者的临床资料.结果 PCNSL以中老年人多见,临床表现复杂多样,病程短,病情进展快.MRI增强扫描病灶多呈均匀明显强化,可单发或多发.19例中术前MRI诊断正确者10例,误诊9例,误诊率为47％.单纯手术7例,术后全脑放疗8例,联合放化疗4例,联合治疗的患者中位生存期明显延长.结论 PCNSL单纯手术治疗效果较差,采用包括手术和放化疗在内的综合治疗可提高疗效.PCNSL临床表现无特征性,影像学特征不典型,是导致误诊的主要原因.
목적 탐토원발성중추신경계통림파류(PCNSL)적진치급오진원인.방법 회고성분석경술후병리증실적19례PCNSL환자적림상자료.결과 PCNSL이중노년인다견,림상표현복잡다양,병정단,병정진전쾌.MRI증강소묘병조다정균균명현강화,가단발혹다발.19례중술전MRI진단정학자10례,오진9례,오진솔위47％.단순수술7례,술후전뇌방료8례,연합방화료4례,연합치료적환자중위생존기명현연장.결론 PCNSL단순수술치료효과교차,채용포괄수술화방화료재내적종합치료가제고료효.PCNSL림상표현무특정성,영상학특정불전형,시도치오진적주요원인.
Objective To explore the diagnosis,treatment and misdiagnosed reasons of primary central nervous system lymphoma(PCNSL).Methods The clinical data of 19 cases with primary central nervous system lymphoma were analyzed retrospectively.Results These patients were middle or old age,with variable clinical features,short course of disease and a rapid process.Enhanced scanning showed the lesion was contrasted evenly and obviously with solitary or multiple.Among the 19 cases,10 cases were correctly confirmed on MRI,but 9 cases were failed,with the misdiagnosis rate of 47％.7 patients only underwent surgery and 8 accepted whole brain radiotherapy after operation.The last 4 patients were given combined therapy including resection,radiotherapy and chemotherapy.The median survival of patients who accepted combined therapy was significantly longer than who accepted surgery alone or postoperative radiotherapy.Conclusions The effect of treatment was poor with surgery alone,and it is critical to use combined therapy including operation,radiotherapy and chemotherapy to elevate therapeutic effect.It was contributed to misdiagnosis since PCNSL showed no characteristic clinical features and no typical radiographic manifestations.