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Central neurogenic hyperventilation with primary cerebral lymphoma: a case report
T Sakamoto1, M Kokubo, K Sasai
1Department of Therapeutic Radiology and Oncology, Graduate School of Medicine, Kyoto University, Japan.
Radiation Medicine
|September 12, 2001
Summary
Central neurogenic hyperventilation (CNH) in an alert patient was linked to cerebral malignant lymphoma. This rare syndrome involves abnormal breathing patterns due to brainstem injury.
Area of Science:
- Neuroscience
- Oncology
- Pulmonology
Background:
- Central neurogenic hyperventilation (CNH) is characterized by hyperpnea with normal/elevated arterial oxygen tension, decreased arterial carbon dioxide tension, and respiratory alkalosis.
- CNH typically occurs in the absence of cardiac or pulmonary disease and is often associated with brainstem lesions.
Observation:
- A 72-year-old male with recurrent central nervous system lymphoma presented with hyperpnea (respiratory rate >30/min) while fully awake and conscious.
- Standard laboratory tests and chest X-ray were normal. Arterial blood gas analysis revealed respiratory alkalosis irrespective of wakefulness or sleep.
- Pulmonary infarction was ruled out. Interventions like rebreathing, diazepam, and oxygen inhalation did not alter the respiratory pattern.
Findings:
- Brain MRI identified two mildly enhanced lesions in the left medulla oblongata and right pons.
- These lesions in the brainstem are implicated as the cause of CNH in this conscious patient.
Implications:
- This case highlights the association between cerebral malignant lymphoma and CNH, particularly in patients with normal consciousness.
- It suggests that brainstem injury, specifically involving the respiratory center, can manifest as CNH.
- Further research into the neuro-oncological basis of respiratory control disorders is warranted.