Mycosis Fungoides Involving the Brain

Weber, M; McGavran, Malcolm H.

doi:10.1001/archneur.1967.00470240083012

Cited by 32 publications

(5 citation statements)

References 11 publications

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“…Involvement of the CNS by MF is rarely reported in living patients, but may be found at post‐mortem examination. 11–22 The clinical manifestations occur from 4 months to 19 years after the diagnosis of MF (for the majority, after 4 years). 14–16 In our patient, they occurred a few months after the MF transformation, as in the recent case reported by Peris et al .…”

Section: Discussionmentioning

confidence: 99%

“… 13 , 18 The frequency of CNS spread in MF is probably underestimated, as it is observed in 11–14% of cases of MF at post‐mortem examination. 21 , 22 Therefore, PCR for the TCR‐γ gene rearrangement may be an important diagnostic tool to detect meningeal involvement. In our patient, PCR analysis not only demonstrated that MF and transformed MF were derived from the same T‐cell clone, as previously reported, 23 but also confirmed the meningeal involvement by the transformed MF, as the lymphomatous cells present in the CSF had lost their CD3 phenotype.…”

Section: Discussionmentioning

confidence: 99%

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Meningeal involvement by a transformed mycosis fungoides following Hodgkin's disease

Beylot‐Barry¹,

Dubus²,

Vergier³

et al. 1999

Br J Dermatol

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A 58-year-old man had long-standing lesions of presumed large plaque parapsoriasis. Following treatment for nodal Hodgkin's disease (HD), these became more infiltrated, with a diagnosis of mycosis fungoides (MF). A few months later, nodules appeared on the right leg, which was lymphoedematous after inguinal irradiation for HD. Histopathological examination showed CD3+, CD30-, CD15- large pleomorphic lymphocytes, leading to the diagnosis of transformed MF. The cutaneous lesions were successfully treated with topical nitrogen mustard and interferon alfa-2b then methotrexate, but his general health worsened with depression and malaise, without specific neurological symptoms or extracutaneous spreading of the lymphoma. Cerebral computed tomographic scan revealed a cerebellar subdural collection, arachnoid cyst and quadriventricular hydrocephaly, initially considered to be non-specific. After a few weeks, clinical symptoms of intracranial hypertension appeared, and a cerebrospinal fluid (CSF) examination revealed meningeal involvement by the lymphoma. These cells were CD3-negative and the diagnosis was confirmed by polymerase chain reaction (PCR) study, which revealed an identical clonal rearrangement of the T-cell receptor gamma gene between cutaneous biopsies and the CSF. Repeated intrathecal injections of methotrexate and cranial irradiation were performed and the patient was still alive after 13 months. This case illustrates the possible meningeal involvement of MF that may be preceded by atypical and mild neurological or psychiatric symptoms, which may be dissociated from the evolution of the cutaneous lesions. Moreover, PCR study may be useful for both diagnosis and monitoring.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Meningeal involvement by a transformed mycosis fungoides following Hodgkin's disease

Beylot‐Barry¹,

Dubus²,

Vergier³

et al. 1999

Br J Dermatol

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“…In our case the time interval was nine weeks. As in our case, the mycosis infiltrate typically involves the Virchow-Robin perivascular spaces.7-12 [15][16][17][18][19] Occasionally, the infiltrates spread to the cerebral parenchyma diffusely,6 1419 form nodules'0 18 19 or infiltrate nerves.8 11 13 18 19 The dominant disorder revealed by histology was progressive multifocal leucoencephalography. This has been previously described in a patient with generalised mycosis fungoides20 without cerebral infiltration with mycosis fungoides.…”

Section: Discussionmentioning

confidence: 82%

Brain biopsy in the diagnosis of cerebral mycosis fungoides

Tremblay

Anderson

Davidson

1982

Journal of Neurology, Neurosurgery & Psychiatry

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SUMMARY A case of cerebral mycosis fungoides co-existing with progressive multifocal leucoencephalopathy presented with dementia. Brain biopsy established the diagnosis of mycosis fungoides after cerebrospinal fluid examinations and computerised tomographic scanning of the brain produced non-specific abnormalities.Mycosis fungoides is a cutaneous lymphoma with characteristic histological and cytological features.' Visceral infiltration is a common necropsy finding and although the nervous system usually is spared,'-5 metastatic involvement of many parts of the nervous system and various non-metastatic neurological complications have been described (table). Cytological examination of the CSF has been helpful in

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“…The most common central nervous system signs and symptoms include nausea, headaches, hemiplegia, paresthesias, hypersomnia, and impaired mentation, gait, and speech. Involvement of cranial nerves, especially II, VI, VII, and VIII, and of peripheral nerves 6–14 has been reported. However, in some cases, patients have been noted to be completely asymptomatic 14 …”

Section: Discussionmentioning

confidence: 99%