[Differential diagnosis of malignant and benign lymphomas of the CNS (author's transl)]

The following results were obtained from 37 cases of malignant lymphomas, including 8 eosinophilic granulomas: 1. Localisation: a. Plasmocytomas occur with approximately the same frequency in the spine and skull, but there is an exceptionally high incidence of multiple myelomas in the thoracic spine. Only in a few cases plasmocytomas of the skull lead to neurological symptoms; particularly when they are localised in the base of the skull. b. Lymphogranulomatosis affects only the thoracic vertebral column and leads less frequently to neurological complications compared with the multiple myelomas. c. Eosinophilic granulomas often attack the calvaria, but can also be found in the spine, the base of the cranium and the flat bones of the pelvis and the scapula. d. Leukaemias showed mainly intracerebral and intramedullary alterations: haemorrhages, leukaemic infiltrations and signs of degeneration. 2.

a. Whenever the calvarium was affected than repeated complaints of headaches prevailed and only very few neurological signs or symptoms were complained. b. Tumors in the base of the cranium caused eye symptoms and various cranial nerve palsies but less frequently increased intracranial pressure. c. Tumors localised in the region of the spinal cord caused early signs like root-irritations (intercoastal neuralgia), diffuse dorsal pain and/or lumbalgia. Symptoms of spinal compression generally of an ascending character then developed within a few weeks. d. Neurological symptoms were the first to manifest themselves in all cases of plasmocytoma in half of our patients with Hodgkin's disease. 3. History and course: a. Generally in the cases of cranial involvement the previous history was less than half a year (visible changes or clear cut symptoms). Spinal tumors on the average had longer histories as did other extra-medullar spinal new growth. Similar courses were seen in multiple myelomas and granulomas. b. Solitary plasmocytomas were very rare but seem to have a considerably better prognosis than in case of multiple occurrence.