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Varicella-zoster viral meningitis mimicking lymphoma
S Park1, V Leymarie, F Agbalika
1Laboratoire d'hématologie, Hôpital Saint-Louis, 1 av Claude Vellefaux, 75010 Paris, France. parksophie@yahoo.com
Abstract:
We report the case of a 30-year-old HIV-infected man admitted for a meningeal syndrome and a zoster rash. The CSF had cytological features suggesting a primary CNS lymphoma (PCNSL). The large lymphoid cells had a fine chromatin with nucleoli, a basophilic cytoplasm with azurophilic granules and high mitotic activity. Several arguments demonstrated the viral origin of the meningitis: the large lymphoid cells were of T origin with no evidence of clonal TCR gamma gene rearrangement. The PCR was positive for Varicella-Zoster Virus (VZV) and EBV DNA. Clinical evolution was favorable under acyclovir. We should be cautious in the differential diagnosis between viral meningitis and PCNSL.
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