【摘要】 目的 探讨颅内B淋巴母细胞淋巴瘤的临床特点、误诊原因及防范措施。方法 回顾性分析2022年11月收治被误诊的1例颅内B淋巴母细胞淋巴瘤患者临床资料。结果 患者因突发言语不利就诊，经头颅CT检查后被误诊为硬膜下血肿。予相应治疗后，有所好转。1个月内多次症状发作，再次入院后行脑MRI平扫及增强结果显示，左侧额颞部颅板下异常强化影，考虑来源硬脑膜恶性病变可能性大，恶性脑膜瘤?淋巴瘤?患者家属要求转上级医院进一步治疗，于上级医院行颅内占位性病变切除术，病理学检查诊断为B淋巴母细胞淋巴瘤。确诊为颅内B淋巴母细胞淋巴瘤，误诊时间1个月。手术治疗后好转出院。结论 颅内的B淋巴母细胞淋巴瘤属于原发性中枢神经系统淋巴瘤（PCNSL），是一种罕见的结外淋巴瘤。PCNSL可能在放射学上被误诊，其与多种疾病具有相似的影像学特征，包括脑膜瘤、硬膜下或硬膜外血肿。临床接诊此类患者时，若初诊疾病治疗效果不佳，应考虑到颅内B淋巴母细胞淋巴瘤，尽早行病理学检查。更多还原

【Abstract】 Objective To explore the clinical features, causes of misdiagnosis and preventive measures of intracranial B lymphoblastic lymphoma. Methods The clinical data of a patient with intracranial B lymphoblastic lymphoma who was misdiagnosed in November 2022 were retrospectively analyzed. Results The patient presented with sudden speech difficulties. After cranial CT examination, it was misdiagnosed as subdural hematoma. After corresponding treatment, there was some improvement. Symptoms occurred multiple times within one month. After re-admission, a plain and enhanced brain MRI scan was performed, which showed an abnormal enhanced shadow under the left frontal and temporal cranial plates. The possibility of a malignant lesion of the dura mater was considered: a malignant meningioma or lymphoma? The patient’s family requested a transfer to a higher-level hospital for further treatment. A resection of the intracranial space-occupying lesion was performed at the higher-level hospital, and the pathological examination confirmed it as B lymphoblastic lymphoma. The misdiagnosis lasted one month. After surgical treatment, the patient improved and was discharged. Conclusion Intracranial B lymphoblastic lymphoma belongs to primary central nervous system lymphoma(PCNSL), which is a rare extranodal lymphoma. PCNSL may be misdiagnosed in radiology and has similar imaging features to many diseases, including meningiomas, subdural or epidural hematomas. When receiving such patients in clinical practice, if the initial therapeutic effect of the disease is not favorable, intracranial B lymphoblastic lymphoma should be considered and pathological examination should be performed as soon as possible.更多还原