中枢神経系原発悪性リンパ腫—脳神経内科医はどのように向かい合うべきか

Primary Central Nervous System Lymphoma: How Do Neurologists Deal with its Management?

中枢神経系原発悪性リンパ腫に脳神経内科医はいかに向かい合うべきか，前回の本誌特集からの7年間を踏まえて再考する。診療面で最大の進歩は，リキッドバイオプシー試料を用いたゲノム解析手法の進歩にあり，リアルタイムで腫瘍細胞の動態や治療反応性の解析，新規クローンの早期発見を可能としてきた。しかし，脳神経内科医の役割は依然，診断・治療に直接関わることではなく，早期診断して専門治療チームに委ねることにある。

Abstract

What are desirable roles of general neurologists in the diagnosis and treatment of primary central nervous system lymphoma (PCNSL)? These issues were discussed 7 years back in the special feature articles of this journal. In the last 7 years genome analyses using liquid biopsy specimens have progressed and are becoming popular in the management of PCNSL, thereby enabling neurosurgeons to avoid invasive brain biopsy. The role of general neurologists in this country is not to be directly engaged in the PCNSL management, but to make an early diagnosis of PCNSL and to refer patients with PCNSL to specialists for a combination of chemotherapy and irradiation therapy.