CAJ | 학술논문

目的：分析原发性中枢神经系统淋巴瘤（PCNSL）的临床特点，提高对 PCNSL 的诊治水平。方法收集我院经病理及免疫组化确诊的 PCNSL 患者28例，回顾性分析患者临床诊治过程中的变化及特点。结果28例中，经立体定向穿刺活检确诊5例，经开颅手术活检确诊7例，其余16例均经开颅单个病灶全切除或次全切除后病理确诊。确诊后，单纯化疗9例，生存期为13～43（25.22±9.35）个月；化疗＋放疗14例，生存期为10～62（31.14±14.48）个月。结论PCNSL 临床特点多变，临床表现缺乏特异性，病理确诊前诊断困难。临床表现结合特异性颅脑 MRI 影像可提示淋巴瘤。手术目的主要是减压并获得病理。肿瘤总体预后较差，确诊后放化疗是主要治疗手段。
목적：분석원발성중추신경계통림파류（PCNSL）적림상특점，제고대 PCNSL 적진치수평。방법수집아원경병리급면역조화학진적 PCNSL 환자28례，회고성분석환자림상진치과정중적변화급특점。결과28례중，경입체정향천자활검학진5례，경개로수술활검학진7례，기여16례균경개로단개병조전절제혹차전절제후병리학진。학진후，단순화료9례，생존기위13～43（25.22±9.35）개월；화료＋방료14례，생존기위10～62（31.14±14.48）개월。결론PCNSL 림상특점다변，림상표현결핍특이성，병리학진전진단곤난。림상표현결합특이성로뇌 MRI 영상가제시림파류。수술목적주요시감압병획득병리。종류총체예후교차，학진후방화료시주요치료수단。
Objective To analyze the clinical characteristics of primary central nervous system lymphoma (PCNSL)and im-prove the diagnosis and treatment of PCNSL.Methods Clinical data of twenty -eight cases of PCNSL patients confirmed by pathologi-cal and immunohistochemical analysis were collected.The changes and characteristics of the clinical diagnosis and treatment were retro-spectively analyzed.Results Among the 28 cases,5 cases were confirmed by stereotactic biopsy,7 cases were diagnosed by cranioto-my,and 1 6 other cases were confirmed by the total or subtotal resection of single lesion.9 cases were treated with chemotherapy.Their average survival time ranged from 1 3 to 43 (25.22 ±9.35)months.1 4 cases were treated with chemotherapy plus radiotherapy.Their average survival time diverted 1 0 to 62 (31 .1 4 ±1 4.48)months.Conclusion Clinical characteristics and manifestations of PCNSL were lacking in specificity.It was difficult to make diagnosis before pathology examination.The clinical manifestation and with some specific brain MRI imaging may suggest lymphoma.The purpose of surgery was to reduce the cranial pressure and achieve the patholog-ical results.The prognosis of PCNSL was usually poor and chemotherapy plus radiotherapy was the main treatment.