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摘要: 我院收治以脊髓病变为首发表现,并经立体定向脑穿刺活检明确的血管内大B细胞淋巴瘤(intravascular large Bcell lymphoma, IVLBCL)患者1例,诊断过程复杂,早期经甲基泼尼松龙及丙种球蛋白治疗后脊髓病灶缩小,颅内病灶变化多端,症状反复,进行性加重,最终行脑穿刺活检明确诊断,在病程4个月时死亡。对诊断不明确及治疗效果不佳的脊髓病变,需保持较高警醒,最大限度地进行组织活检,以防进入诊断陷阱。
关键词: 脊髓炎;淋巴瘤; , B细胞;中枢神经系统
Abstract: A case of intravascular large Bcell lymphoma(IVLBCL) with myelopathy as the first manifestation and confirmed by stereotactic brain biopsy in the department of neurology of PLA Strategic Support Force Characteristic Medical Center was reported and analyzed. The diagnosis process was complicated. The myelopathy lesions were reduced after early treatment with methylprednisolone and rglobulin.The changes of intracranial lesions were multiterminal, with recurrent symptoms and progressive aggravation.The patient was finally diagnosed with a definitive brain biopsy and died in the 4th month of the course of the disease. For myelopathy lesions with unclear diagnosis and poor therapeutic effect, it is necessary to keep a high level of vigilance and conduct biopsy to the maximum extent to avoid entering the diagnostic trap.
Key words: myelitis;lymphoma; , Bcell;central nervous system
于一娇,杜娟,李薇,蔡艺灵,朱琳,路冬煦,刘丽. 以脊髓病变为首发表现的血管内大B细胞淋巴瘤1例并文献复习[J]. 临床荟萃, doi: 10.3969/j.issn.1004-583X.2020.08.015.
Yu Yijiao, Du Juan, Li Wei, Cai Yiling, Zhu Lin, Lu Dongxu, Liu Li. Intravascular large Bcell lymphoma with myelopathy as the first manifestation: a case report and literature review[J]. Clinical Focus, doi: 10.3969/j.issn.1004-583X.2020.08.015.
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链接本文: https://huicui.hebmu.edu.cn/CN/10.3969/j.issn.1004-583X.2020.08.015
https://huicui.hebmu.edu.cn/CN/Y2020/V35/I8/740