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ISSN 0016-3813 (Impreso)

2005, Número 6

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Gac Med Mex 2005; 141 (6)


Linfoma primario del sistema nervioso central en pacientes inmunocompetentes

Guinto-Balanzar G, Félix-Espinoza I, De Anda PS, Aréchiga-Ramos NC, Arteaga-Larios V, Kovacs K

Idioma: Español
Referencias bibliográficas: 42
Paginas: 469-476
Archivo PDF: 127.95 Kb.


RESUMEN

El linfoma primario del sistema nervioso central ha sido informado con frecuencia en pacientes que padecen síndromes de inmunodeficiencia. Sin embargo ésta no es una condición necesaria para su presentación, dado que existen informes de la enfermedad en sujetos inmunológicamente competentes. En el presente trabajo se analizaron en forma retrospectiva, los expedientes de 22 pacientes inmunocompetentes con diagnóstico confirmado de linfoma primario encefálico, se revisó la literatura mundial, con el fin de analizar objetivamente las manifestaciones clínicas, comportamiento radiológico, aspecto histopatológico, dificultades diagnósticas y terapéuticas, así como las consideraciones pro-nósticas. El promedio de edad fue de 65 años y con una relación equitativa hombre/mujer. El tiempo de evolución del cuadro clínico fue de 80.4 días y estuvo dominado por cefalea y déficit neurológico focal. En cuatro pacientes se encontraron lesiones múltiples, mientras que en el resto se trataba de lesiones únicas con localización predominante en la región periventricular de los hemisferios cerebrales. Todos los pacientes fueron manejados inicialmente con esteroides y sometidos a toma de biopsia por estereotaxia. La variedad histológica más frecuente fue la de células grandes difusas y la totalidad de los casos reaccionaron positivamente a antígenos de células B en la inmunohistoquímica. Los 22 pacientes fueron tratados con radioterapia y 10 de ellos además con quimioterapia con metotrexato. La supervivencia promedio fue de 11 meses en los pacientes radiados y de 36 meses en los que se agregó quimioterapia.


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