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原发性中枢神经系统淋巴瘤(primary central nervous system lymphoma, PCNSL)是一种罕见的结外非霍奇金淋巴瘤(non-Hodgkin lymphoma,NHL)。其原发于中枢神经系统(如脑、脑膜)及眼球,但无全身受累,占所有结外淋巴瘤的4%~6%,原发性中枢神经系统肿瘤的4%[1-2]。近年来,PCNSL的发病率呈逐年上升趋势[2]。其组织病理学类型主要为弥漫性大B细胞淋巴瘤[2],表现为高度增殖的肿瘤细胞围绕血管生长,弥漫性浸润中枢神经系统。该病预后较差,未经治疗总生存(overall survival,OS)期仅为1.5个月[3]。诊断PCNSL的主要方法包括立体定向活体组织病理学检查或手术期间的组织病理学检查,但风险高且并发症多,同时活体组织病理学检查造成的微小出血和瘢痕组织也加大了评估治疗效果的难度[4]。因此,寻找无创的影像学方法来准确评估PCNSL十分必要。笔者对近年来PCNSL的影像学研究进展进行综述。
原发性中枢神经系统淋巴瘤的影像学研究进展
Research progress of neuroimaging in primary central nervous system lymphoma
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摘要: 原发性中枢神经系统淋巴瘤(PCNSL)是一种罕见且侵袭性极强的结外非霍奇金淋巴瘤,其占所有结外淋巴瘤的4%~6%,原发性中枢神经系统肿瘤的4%。近年来,PCNSL发病率呈逐年上升趋势,其确诊主要依靠组织病理学检查,包括立体定向活体组织病理学检查和(或)手术期间的组织病理学检查,然而这2种方法均风险较高且并发症较多。因此,寻找能准确评估PCNSL的无创性影像学方法就显得尤为重要。目前,临床常用于评价PCNSL的影像学检查方法主要有CT、 MRI、 PET/CT和PET/MRI。笔者主要对近年来PCNSL的影像学研究进展进行综述。
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关键词:
- 体层摄影术,X线计算机 /
- 磁共振成像 /
- 正电子发射断层显像术 /
- 原发性中枢神经系统淋巴瘤
Abstract: Primary central nervous system lymphoma (PCNSL) is relative rare and highly aggressive extranodal non-Hodgkin's lymphoma, accounting for 4%−6% of all extranodal lymphomas and 4% of primary central nervous system tumors. In recent years, a rising incidence has been recognized. The diagnosis of PCNSL mainly depends on stereotactic biopsy histopathological examination and surgical pathology. However, these procedures have high risks and multiple complications. Therefore, it is especially necessary to find a reliable non-invasive imaging method to evaluate PCNSL accurately. CT, MRI, PET/CT and PET/MRI are used to evaluate PCNSL currently. This review focuses on the research progress of neuroimaging in PCNSL. -
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