Primary Central Nervous System Lymphoma in an Immunocompetent Patient Presenting as Multiple Cerebellar Lesions: A Case Report and Review of Literature

Fortuna, Gliceida M Galarza; Dvir, Kathrin; Febres‐Aldana, Christopher A.; Schwartz, Michael A.; Medina, Ana Maria

doi:10.1177/2324709619893548

Cited by 4 publications

(6 citation statements)

References 19 publications

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“…It characteristically demonstrated a homogeneously enhancing mass, with surrounding vasogenic edema and no central necrosis. In the MRS, the manifestations of PCNSL include increased choline (cho) peak, moderately decreased NAA peak, slightly decreased creatine (Cr) peak, as well as a signi cant increase in Lipid and Lac peaks, which indicated neuron damage and increased tumor cell proliferation [9][10][11][12]. In this case, MRI showed invasive lesions distributed in not only supratentorial but also infratentorial sites, which was different from previous reports.…”

Section: Discussioncontrasting

confidence: 55%

Invasive and Multiple Lesions of Primary Central Nervous System Lymphoma: A Case Report

Zhen

Zeng

Zheng

et al. 2021

Preprint

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Background: Primary central nervous system lymphoma (PCNSL) is rare, malignant, non-Hodgkin lymphoma in the central nervous system. Solitary lesions occurred in the majority of cases. Invasive and multiple lesions were rarely reported. As clinical presentations and neuroimage are variable, early diagnosis is challenging. Case presentation: The patient was a 61-year-old male with normal immunity who firstly experienced drowsiness and dizziness. Cranial magnetic resonance imaging(MRI) revealed invasive and multiple lesions of cerebellar hemisphere, right pons, bilateral thalamus and right frontal lobe with slightly long T1 and T2 signal. Contrast-enhanced MRI demonstrated enhanced signal shadows in the cerebellar hemisphere rather than other areas. Magnetic resonance spectroscopy (MRS) showed lactate (Lac) peak increases and N-acetyl-aspartate (NAA) peak decreases moderately. Histopathological examination revealed infiltrative growth of abnormal lymphoid cells. The immunohistochemical analysis detected the result of CD10(-), Bcl-6(+), MUM-1(+), accessing the diagnosis of diffuse large B-cell lymphoma (Non-GCB).Conclusions: PCNSL with invasive lesions distributed in supratentorial and infratentorial sites were rarely reported, resulting in the delayed diagnosis in this case. This case not only expands the clinical spectrum but also extends the distribution of PCNSL.

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Section: Discussioncontrasting

confidence: 55%

Invasive and Multiple Lesions of Primary Central Nervous System Lymphoma: A Case Report

Zhen

Zeng

Zheng

et al. 2021

Preprint

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“…The vast majority of patients displayed single cerebellar masses, while just 7 of them had multiple lesions (27%). Two patients received a prior diagnosis of breast cancer [ 17 ], one of atrial myxoma [ 18 ] and the last one of myasthenia gravis [ 19 ]. Complete radiographic studies, clinical examination, and bone marrow biopsies revealed a cerebellum-limited disease in all cases with no other localization, including nodal ones.…”

Section: Resultsmentioning

confidence: 99%

Primary Large B-Cell Lymphoma of Immune-Privileged Sites of the Cerebellum: A Case Series and Review of the Literature

Pancetti

Rahal²,

Fernandes³

et al. 2023

Life

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Primary large B-cell lymphoma of immune-privileged sites (IP-LBCL) is a rare malignant hematological neoplasm. Involvement of the cerebellum is even rarer and its diagnosis is often difficult to make due to its non-specific clinical and radiological presentation. Methods: We reported 3 cases of cerebellar IP-LBCL followed at our hospital and reviewed the medical literature to unravel the peculiarities of this poorly studied entity. Outcomes: Analyzing our cases and reviewing the literature, we could collect and study 26 cases of cerebellar IP-LBCL. To the best of our knowledge, this is the largest cohort of such patients currently published. Conclusion: Cerebellar IP-LBCL presents more often in adult females with cerebellum-related focal neurological signs such as ataxia, headache, and nausea. Histological confirmation is mandatory for a correct diagnosis and treatment and all cases feature diffuse large B-cell lymphoma histopathology. Compared to other encephalic IP-LBCL, cerebellar cases seem to include a higher number of cases with germinal center B-cell phenotype and better survival. These differences may be related to a different immune microenvironment and especially immunoregulation that distinguishes the cerebellum from other areas of the CNS.

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“…However, even in cases where patients show damage to similar neural regions, there can be huge variety in the symptoms presented. A 78-year-old woman with a right cerebellar lesion displayed progressive right-sided ataxia [70] . A 63-year-old man with PCNSL masses in the frontal and parietal cortex who was admitted for left hemiplegia following a seizure [71] .…”

Section: Damage On the Central Nervous Systemmentioning

confidence: 99%

“…Methods of locating and assessing the damage from Grommes [20] 70 F Cerebellum Reduced dexterity and clumsiness Galarza et al [70] 78 F Cerebellum Progressive right sided ataxia Zeng et al [77] 52 F Paraventricular Weakness in limbs and mental decline Haddad et al [78] 72 F Third ventricle Acute memory loss and confusion Khanna et al [74] 85 M Lateral/third ventricle Memory deficits, vision loss, altered sensorium Tan et al [75] 53 M Both eyes Retinal whitening and unilateral visual disturbance Guzzetta et al [76] 82 M Spinal cord Weakness in lower extremities and back pain [56,57] .…”

Section: Damage On the Central Nervous Systemmentioning

confidence: 99%

Research on the Damage of the Central Nervous System Lymphoma to the Nervous System

et al. 2023

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Management of central nervous system lymphoma requires multidisciplinary care. The disease can manifest in the context of immunocompromised states or in the context of chronic infections. Nervous system damage from this lymphoma has highly variable presentation that is dependent on the location of the tumor lesions. Damage from disease progression can lead to lasting neurologic deficits and even death. However, some lesions are a consequence of radiation-induced neurotoxicity. This review discusses the sources of and consequences of brain damage due to tumor damage and the associated effect of clinical therapies. We discuss workup, management, and treatments. These include chemotherapy and radiation techniques. We discuss potential complications and avoidance strategies. The review will serve as a user-friendly resource for clinicians.

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Primary Central Nervous System Lymphoma in an Immunocompetent Patient Presenting as Multiple Cerebellar Lesions: A Case Report and Review of Literature

Cited by 4 publications

References 19 publications

Invasive and Multiple Lesions of Primary Central Nervous System Lymphoma: A Case Report

Invasive and Multiple Lesions of Primary Central Nervous System Lymphoma: A Case Report

Primary Large B-Cell Lymphoma of Immune-Privileged Sites of the Cerebellum: A Case Series and Review of the Literature

Research on the Damage of the Central Nervous System Lymphoma to the Nervous System

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