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[Meningitis caused by primary lymphoma of the central nervous system. Report of a case]
Abstract:
The case of a 17 years-old woman, with clinical findings of meningites, without identification of a pathogenic agent is reported. The pacient received treatment for tuberculous and fungi meningitis. In the clinical course were found neoplastic cells in the spinal fluid. Despite the radiologic investigation, the original site of the tumor was not found in life. In the post-mortem examination, a small tumor was discovered in the 4th ventricle. The hystologic examination revealed a primary central nervous system lymphoma, diffuse infiltration of the meninges by tumor cells and proliferation into the central nervous system through the Virchow-Robin space. The clinical course, laboratory investigation and anatomical findings of the tumor are presented. A short revision about the pathogenesis of neoplastic meningites and primary central nervous system lymphoma is made.
Insights
A rare case of primary central nervous system lymphoma presented as meningitis in a teenager. Post-mortem examination revealed a tumor in the 4th ventricle, highlighting diagnostic challenges.
Area of Science:
- Neurology
- Oncology
- Pathology
Background:
- Meningitis can present with diverse etiologies, including neoplastic infiltration.
- Primary central nervous system lymphoma (PCNSL) is a rare malignancy predominantly affecting immunocompromised individuals.
Observation:
- A 17-year-old female presented with clinical signs of meningitis, initially treated for tuberculous and fungal infections.
- Neoplastic cells were identified in cerebrospinal fluid, but the primary tumor site remained elusive during life.
Findings:
- Post-mortem examination identified a small tumor in the 4th ventricle.
- Histological analysis confirmed diffuse infiltration of the meninges by primary central nervous system lymphoma cells, with CNS spread via Virchow-Robin spaces.
Implications:
- This case underscores the importance of considering neoplastic meningitis in unexplained meningitis, especially in younger patients.
- Early diagnosis and treatment of PCNSL are crucial for improving patient outcomes, despite diagnostic difficulties.