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頁籤選單縮合
題名 | Primary Spinal Epidural Non-Hodgkin's Lymphoma in a Child=孩童原發性脊椎硬腦膜上非霍杰金淋巴瘤 |
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作者 | 魏秀惠; 沈俊明; 黃崇濱; 蕭志誠; | 書刊名 | 長庚醫學 |
卷期 | 24:12 2001.12[民90.12] |
頁次 | 頁820-825 |
分類號 | 417.554 |
關鍵詞 | 非霍杰金淋巴瘤; 原發性脊椎硬腦膜上淋巴瘤; 脊髓壓迫; Non-Hodgkin's lymphoma; Primary spinal epidural lymphoma; Spinal cord compression; |
語文 | 英文(English) |
中文摘要 | 非霍杰金淋巴瘤多於轉移時侵犯中樞神經系統,原發性脊椎硬膜上淋巴瘤非常罕見,亦是引起脊髓壓迫少見的原因之一;且此疾病多發生於成人,而其治療方法在成人以手術合併放射線治療為主,化學治療的使用尚無定論。我們報告一個10歲大的小男孩,因為背痛及下半身無力而求診;影像檢查發現一巨大椎硬腦膜上腫瘤,開刀後病理組織診斷為高惡性度之非霍杰金淋巴瘤;其他檢查包括全身電腦斷層掃瞄、腦脊髓液、及骨髓檢查均無發現其他腫瘤存在。病患於憤通後接受化學治療合併放射治療,臨床竑應良好;但於治療過程中發生吞嚥因難的現象,經內視鏡檢查為食道狹窄,最後院接受大腸移植道重建憤通;拎後病患吞嚥情形良好,診斷後42個月仍於完全緩解之狀態,且神經功能正常。原發性脊椎硬腦膜上淋巴瘤多報告發生於成人,且其治療方法常無定診,此疾病發生於孩童之治療經驗更是有限。我們報告此一發生於孩童罕見病例及成功治療之經驗,並整理過去文獻中已發表之病例報告。 |
英文摘要 | Non-hodgkin’s lymphoma usually involves the central nervous system by metastatic disease. Primary spinal epidural non-Hodgkin’s lymphoma (PSENL) is a relatively rare cause of spinal cord compression. It mainly occurs in adults past the 4th or 5th decades. This entity is even rarer in children. The proper treatment modalities are controversial in adults with PSENL. Radiotherapy is the main strategy after surgery; the role of chemotherapy is uncertain. Therapeutic experience in childhood PSENL is extremely limited. We report a 10-year-old boy presenting with backache and bilateral lower leg weakness after minor trauma. Small non-cleaved cell non-Hodgkin’s lymphoma of the epidural space was proven after subtotal tumor removal. Other investigations including computed tomography of the chest and abdomen, one scan, gallium scan, bone marrow aspiration, and cerebrospinal fluid study were all negative for occult disease. The patient received combined therapy with irradiation and chemotherapy after surgery. Esophageal stricture resulting from readiotherapy developed during treatment and colon interposition was performed. He has remained disease free 42 months after the diagnosis with normal functional status. |
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