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Primary malignant lymphoma of the brain in childhood
Insights
A rare pediatric brain lymphoma subtype, small lymphocytic malignant lymphoma, was diagnosed in a 5-year-old boy. This type showed good response to radiotherapy, leading to over 5 years of survival.
Area of Science:
- Pediatric Oncology
- Neuropathology
- Radiation Oncology
Background:
- Malignant lymphoma in pediatric patients is rare.
- Early diagnosis and appropriate treatment are crucial for long-term outcomes.
Observation:
- A 5-year-old boy presented with a year of headache, nausea, and neurological deficits including abducens and facial nerve palsy.
- Neuroimaging revealed a cerebellar hemisphere lesion with enhancement.
- Stereotactic needle biopsy confirmed well-differentiated small lymphocytic malignant lymphoma.
Findings:
- The patient received whole brain and local radiotherapy.
- The lymphoma subtype exhibited low aggressiveness and a favorable response to radiation.
- Long-term survival exceeding 5 years was achieved.
Implications:
- This case highlights the importance of considering rare lymphoma subtypes in pediatric brain tumors.
- Radiotherapy can be an effective treatment for this specific type of pediatric lymphoma.
- Favorable response to radiation suggests a potentially indolent nature of this lymphoma subtype.
Abstract:
A 5-year-old boy presented with a 1-year history of frontal headache and nausea. Neurological examination showed left abducens nerve palsy, left facial nerve palsy, Bruns' nystagmus, and wide-based gait. Neuroimaging demonstrated a lesion with moderate linear enhancement in the left cerebellar hemisphere. He underwent stereotactic needle biopsy. The histological diagnosis was well-differentiated small lymphocytic type of malignant lymphoma. Following the biopsy, the patient underwent radiotherapy (whole brain 30 Gy, local 20 Gy). He has been in good condition for more than 5 years. The long-term survival is attributable to the absence of aggressiveness and the good response to radiation of this subtype of malignant lymphoma.