The clinical investigation of senile primary central nervous system lymphoma / 中国综合临床

ABSTRACT

Objective To investigate the clinical characteristics,diagnosis and treatment of senile primary central nervous system lymphoma.Methods The patients were divided into two groups,one group of the patients underwent chemotherapy and radiotherapy treatment following surgical resection,the other received a combined treatment of chemotherapy and radiotherapy only.The survival were analyzed with log-rank test.Results All of the lesions showed the iso-to slightly high density in the CT scan,and the boundary was unclear,surrounded by edema.Contrast enhancement was found in all of the patients.MRI showed iso-to low T1 and iso-to slightly high T2 signal intensity to the adjacent gray matter.The lesions were surrounded by the edema belt.Contrast enhancement such as rim enhancement or homogeneous enhancement was found in all.The pathological diagnosis was B cell lymphoma(n=32)and T cell lymphoma(n=4).In addition,all of the patients were excluded out of HIV infection and their immune function was normal.The median survival time of the group receiving surgery combination treatment and the group receiving just chemotherapy and radiotherapy were 19 months and 14 months,respectively.There was no significant statistics between the survival time of the two groups.Conclusion It is necessary to differentiate primary central nervous system lymphoma from glioma,metastatic tumor,meningoma,and so on.The surgical resection seems no help for those senile central nervous system lymphoma patients with multi-focus.The diagnosis should be suspected after MRI and obtained by stereotactic biopsy in order to avoid an unnecessary extend of surgery in primary central nervous system lymphoma(PCNSL).