{"created":"2023-06-19T10:44:03.860735+00:00","id":4436,"links":{},"metadata":{"_buckets":{"deposit":"23b10165-682d-485e-9754-8786fdc0c81c"},"_deposit":{"created_by":11,"id":"4436","owners":[11],"pid":{"revision_id":0,"type":"depid","value":"4436"},"status":"published"},"_oai":{"id":"oai:shiga-med.repo.nii.ac.jp:00004436","sets":["6:7:449:450"]},"author_link":["3219","9281","9282","7172","7245","7574","552","6437","3061","806","1956","9283","3219","9281","9282","7172","7245","7574","552","6437","3061","806","1956","9283"],"control_number":"4436","item_3_biblio_info_6":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2023-03-15","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"1","bibliographicPageEnd":"51","bibliographicPageStart":"48","bibliographicVolumeNumber":"36","bibliographic_titles":[{"bibliographic_title":"滋賀医科大学雑誌","bibliographic_titleLang":"ja"}]}]},"item_3_creator_3":{"attribute_name":"著者別名","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"NISHIMURA, Rie","creatorNameLang":"en"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"KUMODE, Mina","creatorNameLang":"en"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"ABE, Kazuki","creatorNameLang":"en"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"IWASA, Masaki","creatorNameLang":"en"}],"nameIdentifiers":[{},{}]},{"creatorNames":[{"creatorName":"FUJISHIRO, Aya","creatorNameLang":"en"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"KANEKO, Shunya","creatorNameLang":"en"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"OGAWA, Nobuhiro","creatorNameLang":"en"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"YOSHIMURA, Yayoi","creatorNameLang":"en"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"FUKAMI, Tadateru","creatorNameLang":"en"}],"nameIdentifiers":[{},{}]},{"creatorNames":[{"creatorName":"MINAMIGUCHI, Hitoshi","creatorNameLang":"en"}],"nameIdentifiers":[{},{}]},{"creatorNames":[{"creatorName":"URUSHITANI, Makoto","creatorNameLang":"en"}],"nameIdentifiers":[{},{},{}]},{"creatorNames":[{"creatorName":"MURATA, Makoto","creatorNameLang":"en"}],"nameIdentifiers":[{},{}]}]},"item_3_description_4":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"【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。","subitem_description_language":"ja","subitem_description_type":"Abstract"},{"subitem_description":"[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.","subitem_description_language":"en","subitem_description_type":"Abstract"}]},"item_3_identifier_registration":{"attribute_name":"ID登録","attribute_value_mlt":[{"subitem_identifier_reg_text":"10.14999/1521.00013513","subitem_identifier_reg_type":"JaLC"}]},"item_3_publisher_32":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"滋賀医科大学雑誌編集委員会","subitem_publisher_language":"ja"}]},"item_3_version_type_15":{"attribute_name":"著者版フラグ","attribute_value_mlt":[{"subitem_version_resource":"http://purl.org/coar/version/c_970fb48d4fbd8a85","subitem_version_type":"VoR"}]},"item_access_right":{"attribute_name":"アクセス権","attribute_value_mlt":[{"subitem_access_right":"open access","subitem_access_right_uri":"http://purl.org/coar/access_right/c_abf2"}]},"item_creator":{"attribute_name":"著者","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"西村, 理恵","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"口分田, 美奈","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"阿部, 和樹","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"岩佐, 磨佐紀","creatorNameLang":"ja"}],"nameIdentifiers":[{},{}]},{"creatorNames":[{"creatorName":"藤城, 綾","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"金子, 隼也","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"小川, 暢弘","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"吉村, 弥生","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"深見, 忠輝","creatorNameLang":"ja"}],"nameIdentifiers":[{},{}]},{"creatorNames":[{"creatorName":"南口, 仁志","creatorNameLang":"ja"}],"nameIdentifiers":[{},{}]},{"creatorNames":[{"creatorName":"漆谷, 真","creatorNameLang":"ja"}],"nameIdentifiers":[{},{},{}]},{"creatorNames":[{"creatorName":"村田, 誠","creatorNameLang":"ja"}],"nameIdentifiers":[{},{}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2023-03-16"}],"displaytype":"detail","filename":"jsums3601p048.pdf","filesize":[{"value":"931.2 kB"}],"format":"application/pdf","licensetype":"license_note","mimetype":"application/pdf","url":{"label":"jsums3601p048","url":"https://shiga-med.repo.nii.ac.jp/record/4436/files/jsums3601p048.pdf"},"version_id":"4313600a-7aa3-47bb-ae82-561289e44096"}]},"item_keyword":{"attribute_name":"キーワード","attribute_value_mlt":[{"subitem_subject":"神経リンパ腫症","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"中枢神経系原発悪性リンパ腫","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"自己末梢血幹細胞移植","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"R-MPV療法","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"Positron emission tomography-computed tomography (PET-CT)","subitem_subject_language":"en","subitem_subject_scheme":"Other"}]},"item_language":{"attribute_name":"言語","attribute_value_mlt":[{"subitem_language":"jpn"}]},"item_resource_type":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"resourcetype":"departmental bulletin paper","resourceuri":"http://purl.org/coar/resource_type/c_6501"}]},"item_title":"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","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"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","subitem_title_language":"ja"},{"subitem_title":"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","subitem_title_language":"ja-Kana"}]},"item_type_id":"3","owner":"11","path":["450"],"pubdate":{"attribute_name":"PubDate","attribute_value":"2023-03-16"},"publish_date":"2023-03-16","publish_status":"0","recid":"4436","relation_version_is_last":true,"title":["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"],"weko_creator_id":"11","weko_shared_id":-1},"updated":"2023-11-22T08:09:03.694544+00:00"}