进行性多病灶性白细胞脑病(PML)是一种少见病,主要伴发于淋巴结病,特别是慢性淋巴细胞白血病、恶性淋巴瘤和肉瘤病,亦发生在无免疫缺陷的患者。患者男性,28岁时右耳旁肿块活检证实为何杰金氏病,淋巴细胞优势型。未治疗,7年后肿瘤累及右下颌区,仍无症状,开始放疗。6月后作诊断性脾切除,随后作倒Y放疗。追踪7年无复发。43岁时,视力模糊,2月后发现中心盲点,视觉皮质电位检查示后视交叉受累。2月后视力下降至1/60,再过2月出现左侧强直性轻偏瘫,失语,此时入院。患者不发热,无颈强硬,无视神经乳头水肿,淋巴结未扪及,胸部X线摄影纵隔不肿大。脑电图示,右大脑半球活动受抑,左侧优势改变。脑锝扫描证明有病灶,左前 Progressive multifocal leucocytic encephalopathy (PML) is a rare disease predominantly associated with lymphadenopathy, particularly chronic lymphocytic leukemia, malignant lymphoma and sarcoidosis, and also in patients with no immunodeficiency. Male patient, 28-year-old next to the right side of the mass biopsy confirmed the disease, the lymphocyte predominance. Not treated, 7 years after the tumor involving the right lower jaw area, still asymptomatic, began radiotherapy. After 6 months for diagnostic splenectomy, followed by inverted Y radiotherapy. Track 7 years without recurrence. 43 years old, blurred vision, found in February blind spots center, visual cortical examination showed cross-involvement affected. Visual acuity decreased to 1/60 in February, and in February there was left ankylosis hemiparesis, aphasia, admission at this time. Patients without fever, no neck stiffness, ignoring the papilledema, lymph nodes not palpable, chest X-ray mediastinal no enlargement. Electroencephalogram, depressed right hemisphere activity, left superiority change. Brain Tc scan proved lesions, left anterior