病史
A 65-year-old immunocompetent patient with headache of 3 months duration
65岁男性，头痛3个月。患者免疫功能正常。
DWI示病灶轻度弥散受限，信号与脑白质相似。
增强后，横断位T1WI示脑室内病灶明显强化。
MRS示Lip峰升高，Cho/Cr比值升高，NAA峰降低。
脑室内原发性中枢神经系统淋巴瘤
- Primary CNS lymphoma is a rare tumor accounting for 4% of all brain neoplasms.原发性中枢神经系统淋巴瘤是一种少见肿瘤，约占全部脑肿瘤的4%。
- It is always the non-Hodgkin type, and the vast majority are B-cell lymphomas.几乎全部都是非霍奇金淋巴瘤，而且绝大部分为B细胞淋巴瘤。
- Intraventricular primary CNS lymphoma is very rare, with few cases reported in the literature.脑室内原发性中枢神经系统淋巴瘤非常罕见，仅可见少量文献报道。
- Lesions are hypo-to-isointense to the gray matter on T1WI and iso-to-hyperintense on T2WI.病灶于T1WI上，与灰质相比呈低或等信号；T2WI呈等或稍高信号。
- In immunocompetent patients, there is almost always solid contrast enhancement.免疫功能正常的患者，病灶通常呈实性强化。
- MR spectroscopy has demonstrated elevated lipid peaks combined with high Cho/Cr ratio and decreased peak of NAA.MRS一般表现为Lip峰升高，Cho/Cr比值升高，NAA峰降低。
- A further workup with CT of the chest, abdomen, and pelvis can help confirm the absence of systemic disease involvement.患者需进一步行胸部、上腹部、盆腔CT，以排除全身其他部位受累。
- Metastases 转移瘤
- Choroid plexus carcinoma 脉络丛癌
- Ependymoma 室管膜瘤
- Meningioma 脑膜瘤
化疗及放疗