摘要
目的探讨以中枢神经系统症状为首发表现的儿童非霍奇金淋巴瘤的临床特点及转归。方法收集2017年1月—2021年12月在北京儿童医院诊治的非霍奇金淋巴瘤中以神经系统为首发症状的患儿临床病理资料,总结其临床特点及转归。结果共纳入44例患儿,其中7例面瘫,9例头疼/头晕/恶性呕吐,11例肢体无力/感觉异常/行走不稳/截瘫表现,18例失明/视力下降/眼球活动受限,3例抽搐,1例尿便潴留表现,1例吞咽困难及言语不清。21例患儿脑脊液检测的异常。44例患儿随访时间平均43个月(19~73)个月,其中8例患儿死亡,40例(91%)患儿在早期化疗阶段神经系统症状能得到明显改善。结论以中枢神经系统症状为首发表现的儿童淋巴瘤更多见于B细胞亚型,对于脑脊液形态学未找到肿瘤细胞的患儿,建议完善脑脊液流式细胞学检测及中枢神经系统影像学检测进一步评估,及时地治疗可使神经系统症状完全恢复。
Objective To investigate the clinical features and outcomes of pediatric non-Hodgkin′s lymphoma(NHL)presenting with central nervous system(CNS)symptoms as the initial manifestation.Methods The clinicopathological data of pediatric NHL patients with CNSsymptoms treated in our hospital from January 2017 to December 2021 were collected,their clinical characteristics and prognosis were summarized.Results 44 cases(7%)had nervous system symptoms as the initial manifestation.Symptoms of nervous system:7 cases of facial paralysis,9 cases of headache/dizziness/malignant vomiting,11 cases of limb weakness/abnormal sensation/walking instability/paraplegia,18 cases of blindness/vision loss/eye movement limitation,3 cases of convulsion,1 case of urinary retention,1 case of dysphagia and unclear speech.44 children were followed up for 19-73months(with an average of 43 months).91%of the children could significantly improve the neurological symptoms in the early stage of chemotherapy.Conclusions NHL with CNS onset is more common in B-cell subtypes.For patients without tumor cells detected by CSF cytology,additional CSF flow cytometry and CNS imaging are recommended for further evaluation.Prompt treatment can lead to complete neurological recovery.
作者
黄爽
段彦龙
金玲
杨菁
张永红
HUANG Shuang;DUAN Yanlong;JIN Ling;YANG Jing;ZHANG Yonghong(Medical Oncology Department,Pediatric Oncology Center,Beijing Children′s hospital,Capital Medical University,National Center for Children′s Health,Beijing Key Laboratory of Pediatric Hematology Oncology,National Key Clinical Discipline of Pediatric Oncology,Key Laboratory of Major Disease in Children,Ministry of Education,Beijing 100045,China)
出处
《中国小儿血液与肿瘤杂志》
2025年第4期252-256,共5页
Journal of China Pediatric Blood and Cancer
基金
白求恩·儿科中青年医生能力提升计划暨儿童临床营养研究专项资助项目。
关键词
中枢神经系统症状
儿童
非霍奇金淋巴瘤
治疗及转归
Central Nervous System symptoms
Children
non-Hodgkin′s lymphoma
Treatment outcomes
