脳内出血にて発症したisolated central nervous system relapse of diffuse large B-cell lymphomaの1例

Intra-tumoral Hemorrhage of a Relapsed CNS Diffuse Large B-cell Lymphoma: A Case Report

Ⅰ．はじめに

　Diffuse large B-cell lymphoma（DLBCL）は，脳以外の節外性DLBCLが比較的長期間を経て，中枢神経系だけに再発する［isolated central nervous system（CNS）relapse］ことがあることが知られているが，脳内出血発症の報告は稀である．今回，われわれはisolated CNS relapse of DLBCLに伴うと考えられる脳内出血発症例を経験したので報告する．

　We report a case of a relapsed central nervous system（CNS）lymphoma with an intra-tumoral hemorrhage. A 75-year-old man was transferred to our hospital because of sensory aphasia. He was diagnosed with a left temporoparietal brain tumor having intra-tumoral hemorrhage. Emergency resection of the tumor was performed. The pathological diagnosis was diffuse large B-cell lymphoma（DLBCL). Chemotherapy and radiation therapy were performed, and the patient achieved remission. Isolated relapsed CNS DLBCL accompanied by an intra-tumoral hemorrhage has been very rarely reported. Immunohistochemistry findings showed increased expression of vascular endothelial growth factor（VEGF）in the cytoplasm of tumor cells. This may correlate to the intra-tumoral hemorrhage, as indicated by previous reports.