Atypical sites of lymphoma in the central nervous system

Abstract

CASEA 51-year-old immunocompetent man presented left-side third nerve palsy. He had previously been diagnosed eight years earlier with an axillary large-cell nonHodgkin lymphoma (NHL), which had been treated with chemotherapy and radiotherapy. MRI showed pineal and hypothalamic lesions (Fig A and B) and computed tomography of the abdomen showed a spleen lesion. After splenectomy, the diagnosis of NHL was made. Laboratory findings showed enhanced serum lactate dehydrogenase (LDH) levels (594 U/l; reference value: 479 U/l) and enhanced IgG levels in the cerebrospinal fluid (15.4 mg/ dl; reference value: 3.4 mg/dl). Increased protein content and cell counts in the cerebrospinal fluid were also observed. The patient was treated with chemotherapy. Eleven months later, the pineal and hypothalamic lesions had disappeared, but a lesion had appeared in the right inferior horn of the right lateral ventricle (Fig C and D).

Neurolymphomatosis of the brachial plexus from atypical primary central nervous system lymphoma lesions: A case report and review of the literature

“…One case of nodal non-Hodgkin lymphoma metastasizing to both the suprasellar and pineal regions has previously been described. [ 10 ] Concurrent lesions in these locations are most often associated with germ cell tumors in children; lymphoma should remain on the differential diagnosis, even if it is an exceedingly rare cause of such lesions.…”

Pineal Gland Lymphoma: Case Report and Literature Review

“…On MRI, although these lesions can appear hypointense to gray matter on T1-weighted imaging and hypointense to isointense on T2-weighted imaging, the hallmark is restricted diffusion due to the increased cellularity. [ 1 6 ] Enhancement is typically homogeneous.…”

“…This is the eighth reported case of CNS lymphoma involving the pineal gland in the literature. [ 2 3 4 5 6 7 ]…”