Central nervous system involvement in haematological malignancies

Abstract

We have reviewed our experience of central nervous system (CNS) involvement in 540 patients with lymphoma or acute leukaemia treated at the Royal Infirmary of Edinburgh between 1979 and 1987. CNS invasion is a significant problem in acute lymphoblastic leukaemia but may well respond to treatment, while in acute non-lymphoblastic leukaemia this complication occurs too infrequently to justify routine CNS prophylaxis. CNS involvement in Hodgkin's disease or non-Hodgkin's lymphoma (NHL) of low-grade malignancy was uncommon, exclusively of the extradural variety, and did not appear to alter the ultimate prognosis. Diffuse leptomeningeal involvement occurred with significant frequency in more aggressive NHL, often while the disease was in systemic remission or during remission induction. The prognosis for leptomeningeal disease or intracranial mass lesions was extremely poor and some form of CNS prophylaxis may be justified in aggressive NHL.

Lymphoma Metastasizing to the Pituitary: An Unusual Presentation of a Treatable Disease

“…Throughout this time the patient was never thirsty, despite at times being in up to one litre negative fluid balance. Basal thyroxine (T4 13.7 pmol/L, TSH 1.91 mU/L) and 09.00 h serum cortisol (164 nmol/L) levels remained within the normal range, but serum testosterone was markedly subnormal, 4.1 nmol/L [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24], with significantly elevated LH 18.9 U/L [1-8] and FSH 35.4 U/L [1-10] levels.…”

CNS Hodgkin lymphoma

“…[1][2][3] Most reports consist of single cases or small case series highlighting our limited knowledge about the clinical characteristics, prognosis, and management of this neurologic complication of HL. [4][5][6][7][8] Consequently, there is no consensus to guide therapeutic decision-making. We gathered data on CNS-HL cases from member sites of the International Primary CNS Lymphoma Collaborative Group (IPCG) in order to better understand the presentation, prognosis, and therapeutic options for patients with CNS-HL.…”

Intracerebral hogkin's lymphoma in a patient with human immunodeficiency virus

“…In the cases reported, as in ours, spinal fluid studies were not explanatory, and diagnosis required brain biopsies or was an autopsy finding. 5,6,7,8 Perhaps, the high risk of infection in these patients (including CNS), the use of empirical treatment, difficult diagnosis and poor outcome might have contributed to fewer cases being reported. A treatment strategy has not yet been defined in these patients.…”