| 정상면역상태에서 발생한 원발성 중추신경계 임파종환자에 대한 ?임상적, 병리학적 고찰 |
| 김경문, 전범석, 윤병우, 이상복, 지제근 |
| 서울대학교 신경과. 병리학교실 |
| Primary CNS Lymphoma in Immunocompetent Patients A Clinical and ?Pathological Study
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| Gyeong Moon Kim, M.D., Beom Suk Jeon, M.D., Byung Woo Yoon, M.D., Sang Bok Lee, M.D., Je Geun Chi, M.D. |
| Department of Neurology, and Pathology,College of Medicine, Seoul National University |
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| Abstract |
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To characterize the clinical manifestations, and histologic features of CNS lymphoma in immunocompetent patients, we collected 15 cases of biopsy proven primary CNS lymphoma.
Evidences of systemic lymphoma, HIV infection, and immune-compromising diseases
were absent at the diagnosis. Brain MRI had been taken before radiation or
chemotherapy, and pathologic specimens were classified according to working formulation
and some cases underwent immunological marker studies. Mean duration of illness was
1. 8 months, mild CSF protein elevation(mean=58mg%) was observed in 5 of 6 patients,
CSF cytology was positive in 2 of 7, and the recurrence rate was 69%. In MR
imaging, tumor size was variable, and 5 patients had multiple lesions at diagnosis. All
patients showed homogeneous(87%) or heterogeneous(13%) gadolinium enhancement, and
secondary tumor change was shown in I case. The tumor had high tendency in
abutting on CSF space(60%), and there was no relationship between histologic types and
MR imaging I s. Classified by working formulation, the intermediate grade
lymphomas(diffuse large cell and small cell cleaved types) were 14 out of 15(93%) and I
showed low grade(small lymphocytic). B-cell lymphoma was 8 out of 9, and T-cell
was only 1. As compared with the previous reported
pathologic data of AIDS-related CNS lymphoma, the histology of lymphoma in
immunocompetent patients were less malignant than those related to AIDS and
immune-compromised patients. |
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