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PRİMER SANTRAL SİNİR SİSTEMİ LENFOMASI: ÜÇ OLGU SUNUMU

Primer santral sinir sistemi lenfoması (PSSSL), santral sinir sisteminde ortaya çıkan eks- tra nodal bir non-Hodgkin lenfoma (NHL) türüdür. Son yıllarda görülme sıklığı giderek artmaktadır. Tüm beyin tümörlerinin yaklaşık %5ini, lenfomaların %1ini oluşturmakta- dır. Tipik olarak yaşlı hastalığı olup, erkeklerde insidansı fazladır. PSSSLında radyoterapi (RT) sık uygulanmakta olup, tüm beyin ışınlaması (30 40 Gy) ve primer tümöre yönelik (10 20 Gy) lokal boost uygulaması, klinik ve radyolojik cevap oranını artırmaktadır. Sade- ce cerrahi uygulanan olgularda rekürrens riski daha yüksek olup, cerrahiye radyoterapi eklenen olgularda sağ kalım 12 18 ay iken kemoterapi ile birlikte kombine tedavi metod- ların uygulanması sağ kalım 37-60 aya kadar uzamaktadır. Bu yazıda kliniğimizde tedavi ettiğimiz üç olgu literatür eşliğinde tartışılarak sunuldu.

Primary Central Nervous System Lymphoma: Report of Three Cases

han ji Primary central nervous system (PCNS) lymphoma is defined as the lymphoma effecting only spinal axis and cranium without systemic symptoms. PCNS Non-Hodgkin s lymphoma is representing 5 % of all primary brain tumors and occurring more frequently in the last years. It occurs frequently in patients with sporadic or acquired immunodeficiency syndromes, which traditionally have been treated with radiotherapy. For nonimmunosupression patients, whole brain Gray irradiation (30 to 40 Gy) with a 1020 Gy local boost to the primary tumor is suggested. Whole-brain radiation therapy with a median survival of 12-18 months was regarded standard chemotherapy introduced combined modality treatment increasing median survival to 37-60 months. The clinical radiographic, pathologic features and prognosis of these rare cases are discussed.

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