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題名 | Steroid-responsive Primary T-cell Lymphoma in the Brain: Report of a Case=對類固醇治療有反應的腦內T細胞淋巴瘤:病例報告 |
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作者 | 李文源; 周德揚; 陳春忠; 周寬基; 林智一; 沈戊忠; 邱昌芳; | 書刊名 | 中臺灣醫學科學雜誌 |
卷期 | 6:3 2001.09[民90.09] |
頁次 | 頁173-178 |
分類號 | 416.291 |
關鍵詞 | 糖皮質激素受體; 類固醇治療; 腦內T細胞淋巴瘤; Glucocorticoid receptor; Steroid treatment; T-cell lymphoma brain; |
語文 | 英文(English) |
中文摘要 | 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;有時候,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,腫塊已延伸到大腦顳葉的兩旁;神經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法染色輔助診斷。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,第三週則達完全緩解。 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,病人應該考慮靜脈注射腎上腺皮質類固醇作為初步治療。 |
英文摘要 | A case of primary TH lymphoma involving the splenium of he 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. |
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