Steroid-Responsive Primary T-cell Lymphoma in the Brain: Report of a Case

腦內T細胞淋巴瘤是一種很少見的腦內惡性腫瘤，它的病灶主要在胼胝體、小腦以及大腦的前葉或顳葉:有時後，病灶可延伸到腦室周圍的白質與基底核。電腦斷層掃描通常能立即找出腦內之異常，尤其是一些具有高密度或同密度的腦內小結:有時，腦內水腫是腦內腫瘤的徵兆，但是確實的診斷仍有待組織病理與免疫組織化學的結果顯示。此次，我們報告一位64歲女性腦內T細胞淋巴瘤病例。此女性病患的胼胝體壓部腫塊是以電腦斷層掃描檢測出來，腫塊巳延伸到大腦顳葉的兩旁；神精外科以立體定位的小針採樣法取生檢體，腫瘤切片則以HE 染色和免疫組織化學染色髮染色輔助診斷。組織病理及免疫組織化學染色法顯示為腦內T細胞淋巴瘤:因為淋巴瘤的細胞質富含糖皮質激素受體，因此，病人以靜脈注射腎上腺皮質類固醇治療三週，並繼續以電腦斷層掃描檢追蹤，病人在治療的第十二天有顯著的改善，第三週則達完全繯解。因此，我們建議，如果腦內T細胞淋巴瘤的細胞質富含糖皮質激素受體，病人應該考慮以靜脈注射腎上腺皮質類固醇作為初步治療。

關鍵字

糖皮質激素受體,類固醇治療,腦用T 細胞淋巴瘤

並列摘要

A case of primary TH lymphoma involving the splenium of the corpus callosum and the parietal lobes was presented in a 64 year-old woman with symptoms of increased intracranial pressure. CT scans showed a mass in the splenium of the corpus callosum extending into both parietal lobes. Perifocal white matter edema with small central necrosis was also noted in the lesion. Malignant T-cell lymphoma was diagnosed following a stereotatic biopsy by histopathology and immunohistochemistry. Because of the marked cerebral edema and the immunohistochemical identifications of glucocorticoid receptors on the lymphoma T cells, dexamethasone was administered intravenously. A dramatic tumor regression was noted by computer-assisted tomography on the 12th day after treatment, and complete remission of the tumor was noted within three weeks. We recommend that steroid treatment should be considered as an initial regimen for intracranial T cell lymphomas positive for glucocorticoid receptors.

並列關鍵字

glucocorticoid receptor,steroid treatment,T-cell lymphoma brain

國際替代計量

Steroid-Responsive Primary T-cell Lymphoma in the Brain: Report of a Case

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