摘要
目的:通过对原发脊髓内弥漫大B细胞淋巴瘤(diffuse large B-cell lymphoma,DLBCL)进行临床分析,提高对原发脊髓内DLBCL的认识。方法:回顾我科2010-01-01~2018-12-01诊治的11例脊髓内DLBCL患者的临床资料,随访观察患者生存状况。结果:11例脊髓内DLBCL患者中,术前误诊为脊髓内胶质瘤9例(81.82%)、脊髓内血管畸形出血1例(9.09%),仅有1例(9.09%)术前考虑淋巴瘤可能,所有病例脊髓内病变均经手术切除,术后病理检查结果均为DLBCL,在我科行化疗、放疗。肿瘤发生部位在颈髓4例(36.36%),胸髓7例(63.64%)。所有患者均制定了随访治疗方案,其中6例(54.55%)KPS(Karnofsky performance status)评分在60%~80%,生活可部分自理;2例(18.18%)发生截瘫及大小便失禁,KPS评分仅有30%~40%;3例(27.27%)在化疗2个周期后失访。结论:原发脊髓内DLBCL在脊髓肿瘤中非常罕见,极易误诊。手术可切除肿瘤,明确性质,缓解局部症状,术后结合全身化疗及全脊髓放射治疗可在某种程度上控制肿瘤进展,提高生活质量,延长生存期。
Objective:To clinical analysis of primary diffuse large B-cell lymphoma(DLBCL),in order to improve the understanding of DLBCL in spinal cord.Methods:Eleven cases with DLBCL in spinal cord that were diagnosed and treated in our department from 2010-01-01 to 2018-12-01,and followed up to observe the survival status of patients.Results:Among the 11 cases with DLBCL in spinal cord,9 cases(81.82%)were misdiagnosed as intramedullary gliomas before surgery,and 1 case(9.09%)was misdiagnosed as intravascular spinal vascular malformation,only 1 case(9.09%)was considered the possibility of lymphoma before surgery.In all cases,the spinal cord lesions were surgically removed.All of postoperative pathological examination results were DLBCL,and all patients were given radiotherapy and chemotherapy in our department.The tumor occurred in 4 cases(36.36%)of cervical spinal cord and 7 cases(63.64%)of thoracic spinal cord.All patients had developed a follow-up treatment plan,of which 6 cases(54.55%)had KPS of 60%-80%,and they can live party by themselves;2 cases(18.18%)hd paraplegia and incontinence,and the KPS score was only 30%-40%;3 patients(27.27%)were lost to follow-up after 2 cycles of chemotherapy.Conclusion:Primary DLBCL in spinal cord is a rare tumor in spinal cord tumors,and it is easy to be misdiagnosed.The tumor can be removed by surgery to clarify the nature and relieve local symptoms.Combined with total spinal cord radiotherapy and chemotherapy after surgery control tumor progression,improve quality of life and prolong survival.
作者
周进茂
孙建军
李金娟
ZHOU Jinmao;SUN Jianjun;LI Jinjuan(The 940th Hospital of Joint Logistic Support Force of PLA, Lanzhou 730050,China)
出处
《西北国防医学杂志》
CAS
2021年第6期516-519,共4页
Medical Journal of National Defending Forces in Northwest China
关键词
脊髓
弥漫大B细胞淋巴瘤
诊断
治疗
spinal cord
diffuse large B-cell lymphoma
diagnosis
treatment
作者简介
周进茂(1968-),男,副主任医师,E-mail:zhoujm1105@sina.com;通讯作者:孙建军,E-mail:610231141@qq.com。
