Analysis Of Imaging Factors,treatment And Prognosis Of Primary Central Nervous System Lymphoma

Primary central nervous system lymphoma(PCNSL)is a rare central nervous system malignant tumor,and its incidence is increasing year by year.Due to its lack of specificity in clinical manifestations,this disease is often misdiagnosed.Delayed treatment,patients often have poor prognosis.Therefore,a retrospective summary of PCNSL has important clinical significance.Objective: To study the imaging findings,pathological features and therapeutic effects of PCNSL,aiming to improve the understanding of clinicians and to better diagnose and treat the disease.Methods: The patients who underwent neurosurgery at the First Hospital of Jilin University from May 2011 to January 1919 and confirmed by pathology as lymphoma after surgery were retrospectively analyzed(excluding immunodeficiency patients).The patient’s imaging findings and histopathology were summarized.The patient’s general condition(gender,age),number of tumors(single,multiple)and location(on the cerebellum,under the cerebellum) and treatment(surgery,surgery + chemotherapy)were used to analyze the patient’s survival.Results: A total of 92 patients were followed up,of which 22 were lost and 34 survived.The complete data of 36 patients were obtained,and all patients had no immunodeficiency.Among the 36 patients,22 were male and 14 were female.The male to female ratio was 1.57:1.The median survival time was 13 months for men and the median survival time was 19 months for women.The age was 4-73 years old,16 cases were ≥60 years old,and the median survival time was 18 months;20 cases <60 years old,and the median survival time was 13 months.All patients underwent CT or MRI,and 15 patients underwent PET/CT.There were 19 cases with single lesion and 17 cases with multiple lesions.The median survival time of single-shot patients was 17 months,and the median survival time of multiple patients was 19 months.There were 32 patients on the cerebellum,4 patients under the cerebellum,the median survival time of the intracranial patients was 19 months,and the median survival time of the subcephalic patients was 5 months.PCNSL showed obvious characteristic manifestations on MRI and showed significant high metabolism on PET/CT.Twenty-three of the 36 patients underwent surgery alone,with a median survival of 4 months;13 patients underwent surgery + chemotherapy with a median survival of 34 months.Data analysis was performed using SPSS 24.0 software.The survival curve was drawn by Kaplan-Meier method,and the single factor was analyzed by log-rank method.The results showed that gender,age,tumor number,and tumor location had no statistical significance on the survival time of patients.Treatment methods(surgery,surgery + chemotherapy)has a statistically significant difference in survival time.Multivariate analysis using Cox regression suggests that treatment is an independent risk factor affecting patient survival.In addition,all 92 patients were followed up for pathological diagnosis.Among them,90 patients were B-cell lymphoma,accounting for 97.8%;1 patient was T-cell lymphoma,accounting for 1.1%;1 patient was Burkitt lymphoma,accounting for 1.1%.Conclusions:(1)MRI shows the characteristic performance of PCNSL,which is beneficial to the early diagnosis of PCNSL.PCNSL shows significant high metabolism on PET/CT,which can assist MRI in the diagnosis of PCNSL.(2)The pathological type of PCNSL is mostly B-cell lymphoma,accounting for 97.8%.T-cell lymphoma and Burkitt lymphoma are rare,accounting for 2.2%.(3)The general condition of the patient(gender,age),the number and location of the tumor are not independent risk factors affecting the survival of the patient,and the treatment method(surgery,surgery + chemotherapy)is an independent risk factor affecting the survival of the patient,indicating simple surgery does not improve the prognosis of patients,and chemotherapy is helpful for the prognosis of patients.The treatment of PCNSL should be based on chemotherapy.