原发性中枢神经系统淋巴瘤2例报告并文献复习OA

Objective To investigate the atypical clinical and imaging features of primary central nervous system lymphoma(PCNSL),establish the pivotal diagnostic value of multimodal imaging combined with early pathological biopsy,and provide theoretical and practical foundations for optimizing treatment strategies for this rare malignancy.Methods A retrospective analysis was conducted on two PCNSL cases admitted to the Department of Neurosurgery,Yichun People's Hospital,Jiangxi Province,from September 2024 to March 2025.Integrated with recent advances in global research over the past five years,this study systematically reviews current diagnostic and therapeutic approaches as well as future directions.Results Both cases presented atypical clinical manifestations and were pathologically confirmed as diffuse large B-cell lymphoma through biopsy.One patient was initially misdiagnosed,declined chemotherapy post-diagnosis,and succumbed two weeks after discharge.The other patient received regular postoperative chemotherapy with favorable outcomes,but experienced accidental death one month post-discharge.Conclusions Primary central nervous system lymphoma(PCNSL)demonstrates occult clinical presentations and significant imaging heterogeneity,contributing to high early misdiagnosis rates.Multimodal imaging facilitates preliminary diagnosis,while pathological biopsy remains the gold standard.Therapeutically,HD-MTX combined with CD20-targeted immunotherapy significantly improves treatment efficacy.Future protocols should integrate molecular subtyping to establish a dynamic interconnected system encompassing"imaging-based early screening,molecular confirmation,and targeted intervention,"thereby advancing evidence-based precision medicine in PCNSL management.