Primäre Lymphome des Zentralnervensystems (ZNS) sind seltene Erkrankungen. Häufig findet sich in ihrer Umgebung eine ausgeprägte Gliaproliferation, die zur Fehldiagnose «Astrozytom» führen kann. Ein 15jähriger Patient wurde wegen eines vermeintlichen Astrozytoms Grad 2 extern mit 40 Gy im Bereich der hinteren Schädelgrube und des Hirnstammes bestrahlt. Ein Tumorrezidiv 5 Monate nach Radiatio führte nach erneuter Biopsie zu einer Revision der Eingangsdiagnose i.S. eines hochmalignen Non-Hodgkin-Lymphoms (NHL) vom B-Zell-Typ (zentroblastisches Lymphom). Nach zyklischer Polychemotherapie, unter anderem mit hochdosiertem Methotrexat und Cytosin-Arabinosid, kam es zur kompletten Remission. Der Patient ist bisher 18 Monate nach Ende der Therapie krankheitsfrei. Eine nochmalige Strahlentherapie erfolgte nicht.

Keywords:
Malignes Lymphom, Primärer ZNS-Tumor, Klassifikation, Chemotherapie
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© 1986 S. Karger AG, Basel
1986
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