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We report a case of neurolymphomatosis as a relapse of primary central nervous system malignant lymphoma. He achieved complete remission with disappearance of neurological symptom by the combination of chemotherapy and autologous peripheral blood stem cell transplantation. [Case] A 50s-year-old male patient was diagnosed as primary central nervous system malignant lymphoma. His disease achieved partial remission with three courses of high-dose methotrexate therapy as induction therapy. The subsequent salvage therapy with carboplatin/etoposide and whole-brain irradiation (39.8Gy) led him complete remission. Nine months later, he developed gait disorder, right upper extremity paralysis, sensory disturbance and pain in both lower extremities and upper right extremities. There were no abnormal findings on head and spine imaging MRI. However, PET-CT scan demonstrated abnormal uptake of FDG in the right brachial plexus and spinal nerve roots. 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  1. 紀要
  2. 滋賀医科大学雑誌
  3. 第36巻, 2023
  4. 第1号(医学編)

神経リンパ腫症で再発した中枢神経系原発悪性リンパ腫の1症例

https://doi.org/10.14999/1521.00013513
https://doi.org/10.14999/1521.00013513
24b2d8bf-6ffe-44c4-a0d5-40656011c3d5
名前 / ファイル ライセンス アクション
jsums3601p048.pdf jsums3601p048 (931.2 kB)
Item type 紀要論文 / Departmental Bulletin Paper(1)
公開日 2023-03-16
タイトル
タイトル 神経リンパ腫症で再発した中枢神経系原発悪性リンパ腫の1症例
言語
言語 jpn
キーワード
主題Scheme Other
主題 神経リンパ腫症
キーワード
主題Scheme Other
主題 中枢神経系原発悪性リンパ腫
キーワード
主題Scheme Other
主題 自己末梢血幹細胞移植
キーワード
主題Scheme Other
主題 R-MPV療法
キーワード
主題Scheme Other
主題 Positron emission tomography-computed tomography (PET-CT)
資源タイプ
資源タイプ識別子 http://purl.org/coar/resource_type/c_6501
資源タイプ departmental bulletin paper
ID登録
ID登録 10.14999/1521.00013513
ID登録タイプ JaLC
タイトル(ヨミ)
その他のタイトル シンケイ リンパシュショウ デ サイハツシタ チュウスウ シンケイケイ ゲンパツ アクセイ リンパシュ ノ 1ショウレイ
著者 西村, 理恵

× 西村, 理恵

WEKO 3219

西村, 理恵

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口分田, 美奈

× 口分田, 美奈

WEKO 9281

口分田, 美奈

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阿部, 和樹

× 阿部, 和樹

WEKO 9282

阿部, 和樹

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岩佐, 磨佐紀

× 岩佐, 磨佐紀

WEKO 7172
ORCID 0000-0003-4116-7184

岩佐, 磨佐紀

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藤城, 綾

× 藤城, 綾

WEKO 7245

藤城, 綾

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金子, 隼也

× 金子, 隼也

WEKO 7574

金子, 隼也

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小川, 暢弘

× 小川, 暢弘

WEKO 552

小川, 暢弘

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吉村, 弥生

× 吉村, 弥生

WEKO 6437

吉村, 弥生

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深見, 忠輝

× 深見, 忠輝

WEKO 3061
e-Rad 40378451

深見, 忠輝

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南口, 仁志

× 南口, 仁志

WEKO 806
ORCID 0000-0003-4450-0106

南口, 仁志

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漆谷, 真

× 漆谷, 真

WEKO 1956
e-Rad 60332326
ORCID 0000-0003-2773-9836

漆谷, 真

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村田, 誠

× 村田, 誠

WEKO 9283
e-Rad 40378063

村田, 誠

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著者別名 NISHIMURA, Rie

× NISHIMURA, Rie

WEKO 3219

NISHIMURA, Rie

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KUMODE, Mina

× KUMODE, Mina

WEKO 9281

KUMODE, Mina

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ABE, Kazuki

× ABE, Kazuki

WEKO 9282

ABE, Kazuki

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IWASA, Masaki

× IWASA, Masaki

WEKO 7172
ORCID 0000-0003-4116-7184

IWASA, Masaki

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FUJISHIRO, Aya

× FUJISHIRO, Aya

WEKO 7245

FUJISHIRO, Aya

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KANEKO, Shunya

× KANEKO, Shunya

WEKO 7574

KANEKO, Shunya

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OGAWA, Nobuhiro

× OGAWA, Nobuhiro

WEKO 552

OGAWA, Nobuhiro

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YOSHIMURA, Yayoi

× YOSHIMURA, Yayoi

WEKO 6437

YOSHIMURA, Yayoi

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FUKAMI, Tadateru

× FUKAMI, Tadateru

WEKO 3061
e-Rad 40378451

FUKAMI, Tadateru

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MINAMIGUCHI, Hitoshi

× MINAMIGUCHI, Hitoshi

WEKO 806
ORCID 0000-0003-4450-0106

MINAMIGUCHI, Hitoshi

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URUSHITANI, Makoto

× URUSHITANI, Makoto

WEKO 1956
e-Rad 60332326
ORCID 0000-0003-2773-9836

URUSHITANI, Makoto

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MURATA, Makoto

× MURATA, Makoto

WEKO 9283
e-Rad 40378063

MURATA, Makoto

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抄録
内容記述タイプ Abstract
内容記述 【緒言】神経リンパ腫症は中枢神経または末梢神経への悪性リンパ腫細胞の浸潤によるリンパ節外悪性リンパ腫と考えられる稀な病態である。今回中枢神経系原発悪性リンパ腫の治療後完全寛解後に末梢神経浸潤にて再発を認め、化学療法と自己末梢血幹細胞移植にて完全寛解を得られた症例を経験したので報告する。【症例】50代男性、20XX年に中枢神経系原発悪性リンパ腫と診断、標準的な治療として大量メソトレキセート療法3回施行にて部分寛解、救援療法としてカルボプラチン、エトポシド療法3回と全脳照射(39.6Gy)を施行し完全寛解となった。9ヶ月後、歩行障害、右上肢麻痺、両下肢・右上肢の感覚障害と疼痛を認めた。頭部および脊椎造影MRIに異常所見はなかった。FDG-PET/CTにて右腕神経叢と脊椎神経根に異常集積を認めた。神経リンパ腫症が強く疑われた。脳脊髄液の細胞診とフローサイトメトリー(FCM)にて中枢神経系原発悪性リンパ腫の再発と診断。神経リンパ腫症と診断した。リツキシマブ、メトトレキサート、ビンクリスチン、プロカルバジン併用療法(R-MPV療法)、髄腔内化学療法、およびブスルファン、チオテパ併用(BU/TT)自己末梢血幹細胞移植を施行し完全寛解に至った。【結論】脳脊髄液細胞診とFCM、FDG-PET/CTを併用することで、神経リンパ腫症の診断が可能となった。中枢神経系原発悪性リンパ腫の再発としての末梢神経の神経リンパ腫症ついては確立された治療法はないことを考えると本症例はR-MVP療法とそれに続くBU/TT併用自己末梢血幹細胞移植の有用性を示唆するものである。
抄録
内容記述タイプ Abstract
内容記述 [Introduction] Neurolymphomatosis is a rare extranodal malignant lymphoma caused by infiltration of malignant lymphoma cells into the peripheral or central nerves. We report a case of neurolymphomatosis as a relapse of primary central nervous system malignant lymphoma. He achieved complete remission with disappearance of neurological symptom by the combination of chemotherapy and autologous peripheral blood stem cell transplantation. [Case] A 50s-year-old male patient was diagnosed as primary central nervous system malignant lymphoma. His disease achieved partial remission with three courses of high-dose methotrexate therapy as induction therapy. The subsequent salvage therapy with carboplatin/etoposide and whole-brain irradiation (39.8Gy) led him complete remission. Nine months later, he developed gait disorder, right upper extremity paralysis, sensory disturbance and pain in both lower extremities and upper right extremities. There were no abnormal findings on head and spine imaging MRI. However, PET-CT scan demonstrated abnormal uptake of FDG in the right brachial plexus and spinal nerve roots. The cerebrospinal fluid cytology and flow cytometry confirmed the diagnosis of neurolymphomatosis as a recurrence of primary central nervous system malignant lymphoma. He underwent R-MPV therapy, intrathecal chemotherapy, and autologous peripheral blood stem cell transplantation with a preconditioning of busulfan and thiotepa, resulting in complete remission of neurolymphomatosis with disappearance of neurological symptoms. [Conclusion] The cerebrospinal fluid cytology and flow cytometry together with PET-CT enabled us to make a diagnosis of neurolymphomatosis. Given that there are no established treatments for neurolymphomatosis of the peripheral nerves as a recurrence of primary central nervous system malignant lymphoma, this case suggests the possible efficacy of the R-MPV therapy followed by autologous peripheral blood stem cell transplantation with busulfan and thiotepa.
書誌情報 滋賀医科大学雑誌

巻 36, 号 1, p. 48-51, 発行日 2023-03-15
出版者
出版者 滋賀医科大学雑誌編集委員会
DOI
関連タイプ isIdenticalTo
識別子タイプ DOI
関連識別子 http://doi.org/10.14999/1521.00013513
関連名称 http://doi.org/10.14999/1521.00013513
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内容記述 application/pdf
著者版フラグ
出版タイプ VoR
出版タイプResource http://purl.org/coar/version/c_970fb48d4fbd8a85
資源タイプ
内容記述タイプ Other
内容記述 Departmental Bulletin Paper
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