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特集 神経系と血管内リンパ腫
文献概要
はじめに
血管内大細胞型B細胞リンパ腫（intravascular large B-cell lymphoma：IVLBCL）は血管内に選択的に腫瘍細胞が増殖する稀な悪性リンパ腫の一型である。2008年秋に改訂されたWHO分類（第4版）において独立した疾患概念となったこの特異な病型は1），近年の診断技術の向上と疾患概念の普及に伴って生前診断率が向上しつつあり，治療においても多くのB細胞リンパ腫と同様に，抗CD20モノクローナル抗体医薬であるリツキシマブの登場によって治療成績が向上していることが示されている。病型の特徴として初発時および再発時において中枢神経病変をきたしやすいことが知られており，特に中枢神経進展・再発は，治療成績が向上しつつある現在においても大きな課題であると考えられている。本稿においては，IVLBCLにおける治療成績および中枢神経病変について概説し，同病変に対する治療戦略について論じてみたい。
血管内大細胞型B細胞リンパ腫（intravascular large B-cell lymphoma：IVLBCL）は血管内に選択的に腫瘍細胞が増殖する稀な悪性リンパ腫の一型である。2008年秋に改訂されたWHO分類（第4版）において独立した疾患概念となったこの特異な病型は1），近年の診断技術の向上と疾患概念の普及に伴って生前診断率が向上しつつあり，治療においても多くのB細胞リンパ腫と同様に，抗CD20モノクローナル抗体医薬であるリツキシマブの登場によって治療成績が向上していることが示されている。病型の特徴として初発時および再発時において中枢神経病変をきたしやすいことが知られており，特に中枢神経進展・再発は，治療成績が向上しつつある現在においても大きな課題であると考えられている。本稿においては，IVLBCLにおける治療成績および中枢神経病変について概説し，同病変に対する治療戦略について論じてみたい。
参考文献
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