Diffuse Large B-Cell Lymphoma in Bilateral Basal Ganglia: A Rare Case Report

Abstract

Primary central nervous system lymphoma (PCNSL) may affect the basal nuclei of the brain. The most common type is diffuse large B-cell lymphoma. This is a case report of an adolescent with rare bilateral lymphoma in the basal ganglia. A male patient aged 16 years had a clinical picture of rapid progression to motor aphasia, dysphagia, and right hemiplegia. Magnetic resonance imaging (MRI) of the skull, along with spectroscopy, indicated lymphoproliferative or neoplastic disease. A biopsy confirmed diffuse large B-cell lymphoma. However, the patient died before starting the definitive treatment. PCNSL is infrequent in the pediatric population, but it has a better prognosis in this age group, especially when diagnosed early. It affects immunodeficient patients more often. In addition to MRI, spectroscopy and positron-emission tomography help clarify the diagnosis. Biopsy is a gold standard for diagnosis, leading to the appropriate initiation of chemotherapy and radiotherapy treatment. PCNSL is rare in young patients. With an early diagnosis, better therapeutic planning is possible. Unfortunately, in the present case, the diagnosis was late, and the patient had an unfavorable outcome.

Primary central nervous system lymphoma: A mirror type presentation in an immunocompetent patient

“…[ 13 ] The predilection sites for this lesion are the periventricular white matter, the corpus callosum, and the basal nuclei. [ 6 ] Cases of bilateral lymphomas have been reported both at the basal nuclei, hypothalamus and even extra-axially in the cerebellopontine angle, unrelated to HIV and other EBV and CMV infections. [ 6 , 19 , 24 ] Mirror pattern CNS lesions have even been reported.…”

“…[ 6 ] Cases of bilateral lymphomas have been reported both at the basal nuclei, hypothalamus and even extra-axially in the cerebellopontine angle, unrelated to HIV and other EBV and CMV infections. [ 6 , 19 , 24 ] Mirror pattern CNS lesions have even been reported. [ 2 ]…”

Primary large B-cell lymphoma involving the cerebellopontine angle mimic acoustic schwannoma: Role of MR Spectroscopy in differential diagnosis. A case report

“…Central nervous system (CNS) lymphoma is a rare and aggressive tumor that may affect the brain, meninges, spinal cord, and eyes [1] . It is classified into primary CNS lymphoma and secondary CNS lymphoma [ 1 – 3 , 13 ]. Secondary CNS lymphoma may be CNS localization of systemic lymphoma or an isolated recurrence [3] .…”