[Neuromeningeal localizations in non-Hodgkin's lymphomas in adults]

A total of 483 adult patients with non-leukemic non-Hodgkin lymphomas (NHL) were reviewed for neuromeningeal (NM) involvement. NM involvement was found in 20 patients (4,1%). Presenting complaints were mainly headache (9 cases) or diplopia (8 cases). Cranial nerve palsies were frequent (12 cases). CSF examination was abnormal in 76% of the patients and was the most reliable diagnostic procedure, but abnormal cells were found in only 50% of the cases. The pattern of the lymphoid proliferation was diffuse in 90% of the cases. The most frequent histological subtypes of NHL were diffuse histiocytic (10 cases) and diffuse lymphocytic poorly differentiated (6 cases). In 65% of the cases, the lymphoma was initially disseminated. NM involvement was inaugural in 20% of the cases and was the only site of proliferation in 35% of the cases. Median survival after the NM localization was only 3 months. Long remissions were achieved in 3 patients with isolated NM involvement. These results are compared to previously published data. The indications of CNS prophylaxis are discussed.