Craniocerebral involvement in lymphoma
| Autor: | José A. Bueri, Néstor Lucatelli, Jorge D. Correale, David A. Monteverde, E. Reich |
|---|---|
| Rok vydání: | 1990 |
| Předmět: |
Adult
Male Pathology medicine.medical_specialty Lymphoma Autopsy lcsh:RC321-571 Central Nervous System Diseases medicine Humans Prospective Studies lcsh:Neurosciences. Biological psychiatry. Neuropsychiatry Immunodeficiency Histiocyte business.industry Brain Middle Aged medicine.disease Coagulative necrosis medicine.anatomical_structure Neurology Female Neurology (clinical) Bone marrow business Complication Infiltration (medical) |
| Zdroj: | Arquivos de Neuro-Psiquiatria, Vol 48, Iss 3, Pp 306-314 (1990) Arquivos de Neuro-Psiquiatria v.48 n.3 1990 Arquivos de neuro-psiquiatria Academia Brasileira de Neurologia instacron:ABNEURO Arquivos de Neuro-Psiquiatria, Volume: 48, Issue: 3, Pages: 306-314, Published: SEP 1990 |
| ISSN: | 0004-282X |
| Popis: | Nine-hundred-eighty-nine patients with lymphoma were studied. Fifty-three cases (5.3%) had lymphomatous craniocerebral infiltration. The principal factors of risk for this complication were: advanced stage of the lymphoma (III or IV), diffuse histiocytic, diffuse poorly differentiated lymphocytic, or mixed cellularity lymphoma histological type, bone marrow involvement, and previous systemic chemotherapy. Thirty-two per cent of the cases of meningeal lymphomatous infiltration were asymptomatic and represented autopsy findings. CT-scan was an useful test to detect brain focal parenchymatous infiltration, as opposed to meningeal infiltration. Mean survival time in patients with lymphomatous meningeal infiltration was 4.3 months, following the combined use of systemic chemotherapy, radiation therapy and intrathecal methotrexate. Two cases had primary cerebral lymphoma, although without associated immunodeficiency Twenty patients (2%) had intracranial hemorrhage, in clear relationship with platelet alterations. Fifteen patients (1.5%) had CNS infection, caused by common bacteriae or opportunistic agents. In 7 cases, the diagnosis was made at autopsy. Thirty-six autopsies were performed. In 8 cases (22%), pathologic findings such as, demyelination, microcalcificat ons, coagulative necrosis, or gliosis, suggested complications from treatment. Fueron estudiados 989 pacientes con linfoma. Tuvieron infiltración linfomatosa craneocerebral 53 casos (5.3%). Los principales factores de riesgo para esta complicación fueron: a. estado avanzado del linfoma (III o IV); b. las formas difusas histiocíticas, difusa pobremente diferenciada o celularidad mixta; c. el compromiso de la medula osea y de la quimioterapia sistêmica previa. En el 32% de los casos la infiltración meníngea linfomatosa fué asintomática y represento hallazgos de autópsia. La tomografía cerebral fué de utilidad para detectar infiltraciones parenquimatosas focales, no así para Ias infiltraciones meníngeas. El tiempo medio de sobrevida en pacientes con infiltración meníngea linfomatosa fué de 4.3 meses, siguientes al uso combinado de terapia radiante a craneo total, quimioterapia sistêmica y/o intratecal con methotrexate. Dos casos con linfoma cerebral primário no estuvieron asociados con inmunodeficiencia. Hemorragias intracraniales se observaron en 20 pacientes (2%), en relaciõn con alteraciones plaquetarias. En 15 casos hubo infección del SNC (1.5%), causada uor bactérias comunes o por agentes oportunistas. En 7 de esos casos el diagnóstico se hizo por autópsia. En 8 de 36 casos autopsiados (22%) se observaron desmielinización, microcalcificaciones, necrosis coagulativa o gliosis, sugestivas de complicaciones por los tratamientos efectuados. |
| Databáze: | OpenAIRE |
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