Primary B-cell central nervous system lymphoma involving fourth ventricle: A rare case report with review of literature

Rao, Ram Nawal; Mishra, Deepti; Agrawal, Pawan K.; Kumar, Raj

doi:10.4103/0028-3886.117608

Cited by 9 publications

(8 citation statements)

References 3 publications

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“…[22] Most PCNSLs arise in the cerebral parenchyma, and to the best of our knowledge, only 18 cases of PCNSL originating from the fourth ventricle (including the present case) have been reported [Table 1]. [1][2][3][4][5][6]8,[12][13][14][16][17][18]23,25,26,28] Our literature review of PCNSL originating from fourth ventricle [ e treatment for PCNSL has traditionally been whole-brain radiation therapy alone; however, median survival has been reported as 8-12 months and the 5-year survival rate as 6%. [20] Due to the limited efficacy of radiation therapy alone, chemoradiotherapy has also been developed.…”

Section: Discussionmentioning

confidence: 99%

Case report and review of the literature of primary central nervous system lymphoma of the fourth ventricle

Kojima

Nakajo

Ichinose

et al. 2022

Surgical Neurology International

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Background: Primary central nervous system lymphoma of the fourth ventricle is very rare. We present a case of primary central nervous system lymphoma originating from the fourth ventricle and review cases reported in the literature. Case Description: A 54-year-old man with no previous medical history presented with headache and nausea. Magnetic resonance imaging showed a homogeneously enhancing tumor in the fourth ventricle and obstructive hydrocephalus. We performed biopsy of the tumor, which was diagnosed pathologically as diffuse large B-cell lymphoma. Although the tumor disappeared after 5 cycles of R-MPV regimen, the patient required repeated ventricular drainage and finally received a ventriculoperitoneal shunt. Complete response was achieved after 2 cycles of high-dose cytarabine chemotherapy with an autologous peripheral blood stem cell transplant. There was no sign of recurrence at 20 months after biopsy. Conclusion: Morbidity arising due to radical resection/radiotherapy of resistant primary central nervous system lymphoma originating from the fourth ventricle could be prevented by ventriculoperitoneal shunting with chemotherapy and autologous blood stem cell transplantation.

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Section: Discussionmentioning

confidence: 99%

Case report and review of the literature of primary central nervous system lymphoma of the fourth ventricle

Kojima

Nakajo

Ichinose

et al. 2022

Surgical Neurology International

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“…1 Few cases of PCNSL (five affecting the hypothalamus and six the fourth ventricle) have been described so far. [10][11][12][13][14][15] To the best of our knowledge, mutual involvement of the hypothalamus and fourth ventricle by PCNSL has not been reported yet.…”

Section: Discussionmentioning

confidence: 99%

Unusual primary central nervous system lymphoma location involving the fourth ventricle and hypothalamus

et al. 2015

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A previously healthy 65-year-old man presented with a two-week history of weight loss, headaches, blurred vision, asthenia and quickly worsening walking impairment. He denied photophobia, neck stiffness, fever, nausea or vomiting.Neurological examination showed global motor slowing, tendency to fall asleep during the clinical examination, generalized weakness against resistance to head and limbs, and osteotendon reflexes present in the upper limbs, but not evoked in the lower limbs. No sensitive deficit or focal neurologic sign was recognizable.Non-contrast multislice computed tomography (MSCT) of the head was performed in the emergency department, showing diffuse periventricular white matter and thalamic mild hyperdensity.Lumbar puncture, blood tests, including serology for HIV and other infections, were negative.On the third day the patient, showing decreased consciousness, underwent magnetic resonance imaging (MRI) with contrast medium injection. MRI revealed the presence of multiple pseudonodular avidly enhancing lesions, supra and infratentorial, crossing the midline, involving the ventricular system, including the fourth ventricle, with extension into the surrounding white matter, the corpus callosum, the thalamus and the hypothamalus.A stereotactic biopsy led to a diagnosis of diffuse large B-cell lymphoma, primarily located in the central nervous system (PCNSL).After the completion of the first phase of treatment (immunotherapy with intravenous Rituximab and corticosteroid), the MRI showed a marked regression of tumor masses.

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“…Les LCP impliquant les ventricules sont généralement développés dans la zone périventriculaire et font saillie dans les cavités ventriculaires. La localisation pure et isolée du quatrième ventricule (V4) est exceptionnelle, sept cas ayant été rapportés à ce jour dans la littérature [4][5][6][7][8][9][10]. Ces cas sont résumés dans le tableau 1.…”

Section: Discussionunclassified

Lymphome primitif à grandes cellules B du quatrième ventricule : cas clinique et revue de la littérature

et al. 2015

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Nous rapportons le cas d'un lymphome B diffus primitif isolé du quatrième ventricule. Il s'agissait d'une femme de 70 ans adressée pour céphalées, vertiges et une démarche instable évoluant depuis trois semaines. L'imagerie cérébrale par résonance magnétique objectivait une lésion du quatrième ventricule bien limitée, se rehaussant de façon intense et homogène après gadolinium faisant évoquer un gliome ou une métastase. Elle a été opérée après qu'un bilan systémique n'a pas retrouvé d'autres localisations (imagerie, biologie sanguine…). L'exérèse complète était réalisée. L'histopathologie a conclu à un lymphome B diffus à grandes cellules avec un phénotype de cellules B activées. La recherche d'autres localisations était négative. Une polychimiothérapie à base de Méthotrexate a été administrée. L'évolution était favorable avec un recul de 10 mois sans récidive. A la lumière de ce cas rare de localisation cérébel-leuse lymphomateuse du 4ème ventricule, une revue exhaustive de la littérature est proposée. Mots clés Lymphome B · Quatrième ventricule · ChimiothérapieAbstract We herein present the case of a 70 year-old woman admitted with a 3 weeks history of headaches, vertigo and gait instability. Brain imaging revealed an isolated wellcircumscribed and enhancing lesion of the fourth ventricle suggesting either a glioma or a metastasis. A systemic checkup including hole body CT-scan did not reveal any other lesion. Therefore a complete microsurgical removal of the tumor was performed with uneventful postoperative course. The pathological assessment confirmed the diagnosis of a diffuse B cell lymphoma with an activated B cells' phenotype. The patient underwent a successful polychemotherapy including Methotrexate. A 10 months follow-up is available with disease-free course. Emphasizing on this very rare case, we provide an exhaustive review of the literature.

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Primary B-cell central nervous system lymphoma involving fourth ventricle: A rare case report with review of literature

Cited by 9 publications

References 3 publications

Case report and review of the literature of primary central nervous system lymphoma of the fourth ventricle

Case report and review of the literature of primary central nervous system lymphoma of the fourth ventricle

Unusual primary central nervous system lymphoma location involving the fourth ventricle and hypothalamus

Lymphome primitif à grandes cellules B du quatrième ventricule : cas clinique et revue de la littérature

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