Total circulating B lymphocyte abnormalities in a primary cerebral localization of non-Hodgkin lymphoma: a case report
Related Experiment Videos
M Guida1, A Casamassima, F Marzullo
1Medical Oncology Division, Oncology Institute, Bari, Italy.
Insights
This case study details a rare primary central nervous system lymphoma in a 43-year-old male. The study highlights significant B-lymphocyte reduction during treatment and recovery, offering insights into this lymphoma subtype.
Area of Science:
- Neurology
- Oncology
- Immunology
Background:
- Primary central nervous system lymphoma (PCNSL) is a rare B-lymphocyte non-Hodgkin's lymphoma.
- PCNSL incidence is increasing, particularly in immunocompromised individuals.
- This study presents a case of PCNSL in a 43-year-old male.
Observation:
- Extraneural involvement was ruled out through comprehensive staging examinations.
- The patient exhibited a significant decrease in circulating B-lymphocytes at diagnosis (4.4%).
- B-lymphocyte counts further dropped during therapy, eventually returning to baseline levels post-treatment.
Findings:
- A notable decrease in peripheral B-lymphocytes was observed during and after treatment for PCNSL.
- The patient survived 10 months post-diagnosis with residual hemiparesis.
- B-lymphocyte levels normalized three months after completing chemotherapy.
Implications:
- Understanding B-lymphocyte dynamics in PCNSL is crucial for monitoring treatment response.
- This case contributes to the understanding of PCNSL's presentation and progression.
- Further research into etiologic and pathogenic factors of PCNSL is warranted.
Abstract:
The authors describe a case of primary central nervous system lymphoma in a 43-year-old male. Interest in this rare form of B-lymphocyte non-Hodgkin's lymphoma is due to its increasing incidence in the last decade, especially in immunodeficient patients. Extraneural involvement was excluded by staging examinations: bilateral bone marrow biopsy from the posterior iliac crest, bipedal lymphography, abdominal CT scan, skeletal, thoracic and gastrointestinal X-rays, spinal puncture, ORL and clinical examination. The peripheral immunologic state was particularly interesting: there was a substantial decrease in total circulating B-lymphocytes at diagnosis (4.4% = 80/mmc; nv 13 +/- 4% = 287 +/- 130/mmc) and a further decrease after 2 and 4 months of therapy (0.16% = 2/mmc). Three months after completion of therapy, the B-lymphocyte level returned to the base level at diagnosis (7% = 88/mmc). At 10 months after diagnosis and 3 months after completion of chemotherapy, the patient is alive and in good health except for the after-effects of a left hemiparesis. The etiologic and possible pathogenic factors are considered.