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Systemic lymphoma mimicking acute disseminated encephalomyelitis
Alexander G Bassuk1, Gesina F Keating, David A Stumpf
1Department of Pediatrics, Division of Neurology, Children's Memorial Hospital, Chicago, Illinois 60614, USA.
Pediatric Neurology
|February 27, 2004
Summary
A rare case of T-cell lymphoma in an immunocompetent child presented with central nervous system symptoms, initially mimicking acute disseminated encephalomyelitis and later relapsing with new neurological signs.
Area of Science:
- Neurology
- Pediatric Oncology
- Immunology
Background:
- Acute disseminated encephalomyelitis (ADEM) is an immune-mediated inflammatory demyelinating disease of the central nervous system.
- T-cell lymphoma is a type of non-Hodgkin lymphoma that develops from a specific type of white blood cell called T-cells.
- Central nervous system (CNS) involvement in pediatric lymphoma is uncommon, particularly in immunocompetent individuals.
Observation:
- A 10-year-old immunocompetent male initially presented with symptoms suggestive of ADEM.
- The patient experienced a relapse three months later, exhibiting new neurological deficits and lymphadenopathy.
- Diagnostic lymph node and stereotaxic brain biopsies confirmed the presence of T-cell lymphoma.
Findings:
- This case highlights a rare presentation of T-cell lymphoma in a child.
- The initial symptoms mimicked ADEM, delaying the diagnosis of lymphoma.
- The relapse with neurological signs and lymphadenopathy was crucial for accurate diagnosis.
Implications:
- This case underscores the importance of considering rare diagnoses in pediatric neurological disorders, even in immunocompetent patients.
- Early recognition and diagnosis of CNS lymphoma are critical for effective treatment and improved outcomes.
- Further research into the pathogenesis and diagnostic markers of CNS T-cell lymphoma in children may be warranted.