From the archives of the AFIP - Primary central nervous system lymphoma: Radiologic-pathologic correlation
From the archives of the AFIP - Primary central nervous system lymphoma: Radiologic-pathologic correlation
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DOI：
10.1148/radiographics.17.6.9397461
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发表时间：
1997-11-01
期刊：
影响因子：
5.5
通讯作者：
Jones, RV
中科院分区：
文献类型：
--
作者：
Koeller, KK;Smirniotopoulos, JG;Jones, RV
原发性中枢神经系统淋巴瘤曾经是一种极其罕见的肿瘤，现在的患病率仅次于脑膜瘤和低级别星形细胞瘤。由于特殊的免疫组化染色，近年来对原发性中枢神经系统淋巴瘤的认识大大增加。几乎所有原发性CNS淋巴瘤都由B细胞组成。虽然在某些情况下已经提出了病毒原因，但疾病的确切原因仍在调查中。原发性中枢神经系统淋巴瘤具有明显的血管周围扩散的亲和力。虽然大体病理检查可见颗粒状结节，但显微镜下可见弥漫性扩散，这是肿瘤产生远处病变和局部复发的原因。肿瘤细胞密度高，好发于脑室周围，这也解释了其在CT平扫上的典型高密度表现和在T2加权磁共振成像上的低密度表现。几乎所有的病变都可以用造影剂增强。虽然原发性中枢神经系统淋巴瘤患者的总体预后仍然很差，但放射治疗和化学治疗这种曾经一致致命的疾病已经取得了一些进展。
Once an extremely rare neoplasm, primary lymphoma of the central nervous system (CNS) now ranks behind only meningiomas and low-grade astrocytomas in prevalence. Understanding of primary CNS lymphoma has increased greatly in recent pears as a result of special immunohistochemical stains. Virtually all primary CNS lymphomas are composed of B cells. Although a viral cause has been suggested in some cases, the exact cause of the disease is still under investigation. Primary CNS lymphoma has a distinct affinity for perivascular extension. Although granular nodules may be seen at gross pathologic inspection, diffuse microscopic spread is always present, which accounts for the ability of this tumor to produce distant disease and local recurrences. The dense cellularity of the tumor and its predilection for the periventricular region also explains its typical hyperattenuated appearance on unenhanced computed tomographic scans and hypointensity on T2-weighted magnetic resonance images. Virtually all lesions enhance with contrast material. Although the overall prognosis for patients with primary CNS lymphoma remains poor, some advances have been made with radiation therapy and chemotherapy for this once uniformly fatal disease.