Clinical Analysis Of 46 Cases Of Intracranial Lymphoma

Purpose: PCNSL appears to be isolated brain injury in up to 70% of patients with normal immune function.It usually occurs in the on-screen area and prefers the surrounding white matter.It has unique biological characteristics and characteristic clinical manifestations,and the overall long-term survival rate is about 20-40%.With the advent of chemical radiology protocols,clinical outcomes have improved,but disease recurrence and adverse neurocognitive sequelae remain major clinical challenges and lack clinical trial data to guide the treatment of the disease.The purpose of this study was to analyze 46 patients with pathologically confirmed PCNSL from February 2004 to March 2018,and to summarize their clinical features,auxiliary examination,diagnosis,follow-up treatment,and prognosis.The primary central nervous system.Clinical evidence supports the early diagnosis and treatment of systemic lymphoma.Clinical data and methods: Retrospectively reviewed the general data,clinical manifestations,imaging findings,pathological biochemical indicators,follow-up treatment and follow-up of 46 cases of primary intracranial lymphoma diagnosed by pathology from February 2004 to March 2018 in China Medical University.Medical treatment features.All data were retrospectively analyzed,Kaplan-Meier method was used for survival analysis,and log-rank test was used to analyze the relationship between clinical factors and survival time.P < 0.05 indicates statistical significance.Among the46 patients,24 were male and 22 were female.The male-female ratio was 1.09:1,and there was no significant difference between male and female.There are 15 cases under the age of 41-83 years old,50 years old(including 50 years old),and 31 cases over 50 years old.Except for one patient with prolactinoma,no other brain tumors were found in the remaining patients.All patients underwent ultrasound and PET examination without any other systemic lymphoma.All patients with history had no history of organ transplantation and application of immunosuppressive agents,and no history of human immunodeficiency virus(HIV)infection.Clinical manifestations: There were 24 cases of headache,21 cases of unresponsiveness,23 cases of dyskinesia,6 cases of visual impairment,1 case of epilepsy,and 3 cases of hearing impairment.The lesions weremostly located in the frontal lobe(11 cases,23.91%),temporal lobe(8 cases,17.39%),and the ratio of single lesions to multiple cases was 4.75:1(38 cases in a single case and8 cases in a multiple case).Result: All patients underwent CT and brain MRI plain scan plus enhanced examination before surgery to be diagnosed as PCNSL.Most of the tumors are on the screen.38 cases were single lesions,accounting for the majority,and 8 of them were multiple lesions.Pathological examinations were lymphoma,and diffuse large B-cell tumors accounted for 73.91%.Among the 46 patients,13 patients underwent stereotactic surgery to confirm the pathology.After 33 surgical resection,the pathological diagnosis was PCNSL.Among them,2 patients died of worsening after the diagnosis,and the remaining patients followed up with follow-up treatment such as radiotherapy and chemotherapy.Follow-up results: Among the 13 patients diagnosed as PCNSL by stereotactic biopsy,the survival time of patients who received postoperative radiotherapy and chemotherapy combined therapy was 2 years;patients without postoperative radiotherapy alone;patients who underwent chemotherapy only had the shortest survival 4 Months,up to 5 years.Of the33 patients diagnosed with PCNSL who underwent lesion resection,the shortest survival time was 20 days for patients who did not follow up with radiotherapy and chemotherapy,up to 3 years;the shortest survival time was 4 months for patients following follow-up radiotherapy,up to 4 years for 4 years.Month;the shortest survival time for patients who follow-up chemotherapy is 5 months,and the longest time is 6 years.Conclusion: 1.The median age of primary central nervous system lymphoma was 60 years old,male: female ratio was 1.09:1,and there was no significant difference between male and female.The location of intracranial lymphoma is related to the survival rate of patients,and the survival time of patients with temporal lobe is longer.2,pathological diagnosis of PCNSL sample analysis showed that the choice of major excision surgery and the choice of stereotactic biopsy had no significant effect on the prognosis of patients.The survival rate of patients undergoing chemoradiotherapy is superior to those who do not undergo follow-up after surgery.3.Histopathology: Diffuse large B-cell lymphoma(DLBCL)is the most important pathological type.This sample accounted for 73.91%,and bcl-6 had a higher positive rate in DLBCL.