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本文首次报告2例0期慢性淋巴细胞白血病(C-LL)发生中枢神经系统(CNS)受累: 例1,女,59岁。进行性视力丧失2月伴左脸、左臂麻木及右腿无力。眼底见视神经萎缩,中心暗点及视敏度下降。肝、脾及淋巴结不肿大,红细胞比积及PC正常,WBC 9200/μl,淋巴细胞56%;骨髓活检符合CLL,脑脊液(csf)白细胞117/μl,淋巴细胞占96%且形态异常。置Ommaya脑脊液贮存器交替注入MTX及Ara-C并颅脑放疗3000 rad;治疗1月视敏度改善,神经症状消失,鞘注化疗6月结束至今20月仍缓解。例2,女,57岁,共济失调6月伴头晕、双上肢麻木及体重下降。检查见右腿震颤,行走困难及隆伯
This is the first report of 2 cases of central nervous system (CNS) involvement in stage 0 chronic lymphocytic leukemia (C-LL): Case 1, female, 59 years old. Progressive vision loss in February with left face, left arm numbness and right leg weakness. See optic nerve atrophy fundus, dark spots and visual acuity decreased. Hepatic, spleen and lymph nodes did not enlarge, hematocrit and normal PC, WBC 9200 / μl, lymphocytes 56%; bone marrow biopsy consistent CLL, cerebrospinal fluid (CSF) leukocytes 117 / μl, lymphocytes accounted for 96% and abnormal morphology. Ommaya cerebrospinal fluid reservoir alternately injected with MTX and Ara-C and cranial radiation 3000 rad; treatment of visual acuity improved in January, the disappearance of neurological symptoms, intrathecal chemotherapy until the end of June so far still eased. Example 2, female, 57 years old, ataxia June with dizziness, numbness of both upper extremities and weight loss. Check see the right leg tremor, walking difficulties and Long Bo