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Primary cerebral lymphoma manifested by dementia
C M Zarabi1, J C Parker, M Wasylenko
1Department of Pathology, University of Missouri-Kansas City School of Medicine.
Insights
Primary cerebral lymphoma (PCL) is rare, often presenting differently in immunocompromised versus immunocompetent individuals. This study highlights PCL presenting as dementia in immunocompetent patients, suggesting it be considered in Alzheimer's disease diagnoses.
Area of Science:
- Neurology
- Oncology
- Neuro-oncology
Background:
- Primary cerebral lymphoma (PCL) is a rare brain tumor, constituting less than 1% of intracranial neoplasms.
- Clinical presentation of PCL varies significantly based on immune status.
- In immunocompromised patients, PCL typically manifests as focal neurological deficits.
Observation:
- In immunocompetent individuals, PCL commonly involves the leptomeninges, presenting with meningeal signs.
- A unique case of leptomeningeal lymphoma presenting as dementia in an immunocompetent patient is described.
- This presentation has not been previously reported in the medical literature.
Findings:
- Leptomeningeal lymphoma can manifest as dementia, mimicking neurodegenerative conditions.
- The study expands the known clinical spectrum of primary cerebral lymphoma.
- Differential diagnosis for dementia should include leptomeningeal lymphoma in immunocompetent patients.
Implications:
- This finding necessitates broadening the differential diagnosis for dementia, especially in immunocompetent individuals.
- Early recognition of leptomeningeal lymphoma presenting as dementia can lead to timely diagnosis and treatment.
- Further research is warranted to understand the mechanisms and prevalence of PCL presenting with cognitive decline.
Abstract:
Primary cerebral lymphoma (PCL) accounts for less than 1% of intracranial neoplasms. In immunocompromised patients, multicentric lymphoma of the brain is typically manifested by focal neurologic deficits. In the immunocompetent individual, PCL involves leptomeninges and presents meningeal signs. Leptomeningeal lymphoma manifested by dementia has not been previously reported and should be included in the differential diagnosis of patients with Alzheimer's disease.