Primary central nervous system lymphoma presenting as an acute massive intracerebral hemorrhage: case report with immunohistochemical study
Primary central nervous system lymphoma presenting as an acute massive intracerebral hemorrhage: case report with immunohistochemical study
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DOI：
10.1016/j.surneu.2007.04.009
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发表时间：
2008-09-01
影响因子：
--
通讯作者：
Choi, Chan
中科院分区：
文献类型：
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作者：
Kim, In-Young;Jung, Shin;Choi, Chan
背景：原发性中枢神经系统淋巴瘤的首发出血极为罕见，目前只有2项研究报道了这种情况。我们经历了一例原发性中枢神经系统淋巴瘤的出血，但其特征与上述两项研究中的不同。我们报告一例原发性中枢神经系统淋巴瘤，表现为急性大面积脑出血，导致精神灾难性恶化，并伴有免疫组织化学特征。病例描述：一位49岁女性因精神状态突然恶化而入院。即刻CT扫描显示左侧额叶有大量脑出血，伴有病灶周围水肿和中线移位。急诊手术后血肿全部切除，包括与邻近正常脑组织相鉴别的异常病变。组织病理学诊断为非霍奇金淋巴瘤，弥漫性、大细胞型，13细胞型急性出血，免疫组织化学结果显示VEGF高表达，CD34中等阳性。结论：原发中枢神经系统淋巴瘤可表现为急性大块脑出血，免疫组化结果进一步证实了VEGF活性与原发中枢神经系统淋巴瘤出血有关。(C)2008 Elsevier Inc.保留所有权利。
Background: Hemorrhage at presentation in primary CNS lymphoma is extremely rare and only 2 studies have reported it. We experienced a case of hemorrhage in primary CNS lymphoma, but the feature was different from those in the 2 studies mentioned. We report a case of primary CNS lymphoma presenting as an acute massive ICH causing catastrophic mental deterioration, along with immunohistochemical profiles.Case Description: A 49-year-old woman was admitted with sudden deterioration of mental status. Immediate CT scan showed a massive ICH in the left frontal lobe with perilesional edema and midline shifting. Emergency operation was performed and the hematoma was removed gross totally, including the abnormal lesions distinguished from adjacent normal brain. The histopathologic diagnosis was non-Hodgkin lymphoma, diffuse, large, 13 cell type with acute hemorrhage, and immunohistochemistry results showed high VEGF immunoreactivity and intermediate CD34 immunoreactivity.Conclusion: Primary CNS lymphoma can present as an acute massive ICH, and immunohistochemisty in the present study strengthened the suggestion that VEGF activity is related to the hemorrhage in primary CNS lymphoma. (c) 2008 Elsevier Inc. All rights reserved.