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[Primary central nervous system lymphoma mimicking ventriculitis]
Shiro Yamamoto1, Seiji Nagano, Sumiya Shibata
1Department of Neurology, Kobe City Medical Center General Hospital.
Rinsho Shinkeigaku = Clinical Neurology
|November 15, 2013
Summary
A rare case of primary central nervous system lymphoma (PCNSL) presented as ventriculitis. This B cell lymphoma mimicked infection, highlighting the importance of considering PCNSL in differential diagnoses.
Area of Science:
- Neurology
- Oncology
- Pathology
Background:
- Primary central nervous system lymphoma (PCNSL) is a rare malignancy confined to the brain, spinal cord, meninges, or eyes.
- Ventriculitis, inflammation of the ventricles, is typically caused by infection and presents with neurological symptoms.
Observation:
- A 66-year-old man exhibited worsening bradykinesia, gait issues, disorientation, and incontinence.
- MRI revealed ventricular dilatation and lesions mimicking ventriculitis. CSF analysis showed lymphocytic pleocytosis, elevated protein, and low glucose.
- Cerebrospinal fluid flow cytometry and PCR indicated a B cell lymphoma, confirmed by biopsy as diffuse large B cell lymphoma.
Findings:
- The patient was diagnosed with primary central nervous system lymphoma (PCNSL) with limited intraventricular spread.
- Diagnostic workup excluded infectious causes and systemic lymphoma.
- The findings underscore the potential for PCNSL to present atypically, mimicking infectious ventriculitis.
Implications:
- This case highlights the critical need to include PCNSL in the differential diagnosis of ventriculitis, especially when infectious etiologies are ruled out.
- Early recognition and diagnosis of intraventricular PCNSL are crucial for timely and appropriate treatment, potentially improving patient outcomes.
- Further research into the specific presentation and management of intraventricular PCNSL is warranted.
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