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Neurología
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Neurología
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Neurología
Article . 2013
License: Elsevier Non-Commercial
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Neurología
Article . 2013
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Linfomas primarios del sistema nervioso central

Authors: M. Gelabert-González; D. Castro Bouzas; R. Serramito-García; C. Frieiro Dantas; E. Aran Echabe;

Linfomas primarios del sistema nervioso central

Abstract

Resumen: Introducción: Los linfomas primarios del sistema nervioso central son una variedad poco frecuente de linfomas no hodgkinianos que constituyen alrededor del 4% de los tumores del sistema nervioso central. Pacientes y métodos: realizamos una revisión retrospectiva de 24 pacientes diagnosticados de linfoma primario del sistema nervioso central entre enero de 1990 y diciembre de 2010. Todos los pacientes fueron diagnosticados con resonancia magnética y confirmados quirúrgicamente. Resultados: De los 24 pacientes analizados, 4 presentaban inmunodeficiencia. La media de edad era de 59,3 años (intervalo 13-79) y la relación entre varones y mujeres de 1 a 1,1. El deterioro cognitivo (33,4% de los pacientes) y la cefalea (22,5%) fueron los signos de presentación más frecuentes. El diagnóstico se realizó en 13 casos (54%) tras llevar a cabo una craneotomía y en los otros 11 (46%) mediante biopsia estereotáctica. La distribución histológica mostró que 22 casos (91,6%) eran linfomas tipo B, un caso un linfoma anaplásico de células gigantes y el otro correspondió a un linfoma de células T. La supervivencia media fue de 12,8 meses y a un año del 37,5%. Conclusiones: Los linfomas cerebrales primarios se presentan alrededor de la sexta década de la vida y clínicamente se manifiestan con deterioro cognitivo, cefalea y déficits neurológicos focales. El 75% de los pacientes (18 casos) presentaban únicamente una lesión intracraneal y el restante 25% (6 pacientes) entre 2 y 4 lesiones. El estado clínico preoperatorio constituye el factor pronóstico más importante. Abstract: Introduction: Primary central nervous system lymphoma is a rare subtype of extranodal non-Hodgkin lymphoma that accounts for 4% of central nervous system tumours. Patients and methods: Retrospective review of 24 patients diagnosed with primary central nervous system lymphoma between 1990 and 2010. All patients were diagnosed using magnetic resonance imaging and the diagnosis was confirmed surgically. Results: Of the 24 patients analysed, all except 4 were immunocompetent. Median age at diagnosis was 59.3 years (range 13-79) and the sex ratio (male to female) was 1:1.1. Cognitive decline (in 33.4%) and headache (in 25%) were the most common complaints. Diagnosis was performed In 13 cases (54%) following craniotomy and in the other 11 cases (46%) after stereotactic biopsy. Breakdown by pathology was as follows: 22 cases of B-cell lymphoma (91.6%), 1 case of anaplastic large-cell lymphoma, and 1 case of T-cell lymphoma. Mean survival time was 12.8 months with an overall 1-year survival rate of 37.5%. Conclusions: Primary central nervous system lymphoma often presents in the sixth decade with cognitive decline, headache, and focal neurological deficits. A single intracranial lesion was present in 75% of the patients (18 cases), and the remaining 25% (6 cases) had between 2 and 4 lesions. Preoperative clinical status was the most important factor determining prognosis. Palabras clave: Biopsia estereotáctica, Linfoma no hodgkiniano, Linfoma primario del sistema nervioso central, Metotrexate, Tumor cerebral, Keywords: Stereotactic biopsy, Non-Hodgkin lymphoma, Primary central nervous system lymphoma, Methotrexate, Brain tumour

Related Organizations
Keywords

Clinical Neurology, Neurology. Diseases of the nervous system, RC346-429

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    This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
7
Average
Average
Average
gold