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Harvest and Primary Culture of Leptomeningeal Lymphatic Endothelial Cells
06:44

Harvest and Primary Culture of Leptomeningeal Lymphatic Endothelial Cells

Published on: September 8, 2023

[Potent primary leptomeningeal lymphoma masquerading as tuberculous meningitis - a case report]

Soutarou Taguchi1, Jun-ichi Niwa, Keisuke Tokui

  • 1Department of Neurology, Aichi Medical University.

Rinsho Shinkeigaku = Clinical Neurology
|July 14, 2012
PubMed

Insights

A man initially diagnosed with tuberculous meningitis improved with treatment but later developed lymphoma. Repeated diagnostic imaging revealed occult lymphoma, highlighting the need for careful observation in complex cases.

Area of Science:

  • Neurology
  • Oncology
  • Infectious Diseases

Background:

  • Tuberculous meningitis can present with non-specific neurological symptoms.
  • Early diagnosis and treatment are crucial for managing tuberculous meningitis.

Observation:

  • A 45-year-old man presented with fever, mutism, and memory loss, initially treated for tuberculous meningitis with steroids and anti-tubercular drugs.
  • Initial MR imaging showed infarctions and vasculitis, while CSF revealed pleocytosis and elevated protein. Adenosine deaminase activity was accelerated.
  • Despite initial improvement, symptoms recurred, prompting further investigation.

Findings:

  • Restudy revealed enhanced accumulation in lymph nodes on gallium-scintigraphy.
  • A lymph node biopsy confirmed diffuse large B-cell lymphoma, indicating an occult malignancy.
  • The initial presentation mimicked tuberculous meningitis, delaying lymphoma diagnosis.

Implications:

  • This case underscores the importance of vigilant and repeated diagnostic evaluations for patients with persistent or relapsing neurological symptoms.
  • Occult lymphomas can present with symptoms mimicking infectious or inflammatory conditions, necessitating a broad differential diagnosis.
  • Integrated diagnostic approaches combining imaging and biopsy are vital for identifying challenging malignancies.

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