Primary fourth ventricular B-cell lymphoma in an immunocompetent patient

Fabiano, Andrew J.; Syriac, Susanna; Fenstermaker, Robert A.; Qiu, Jingxin

doi:10.5414/np300658

Cited by 7 publications

(8 citation statements)

References 11 publications

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“…[4,6] e presence 1]. [1,3,[7][8][9][10][11]13] e first report was dated 1977 by Werneck et al [13] Immunosuppression is a risk factor for the growth of this pathology and however is more prevalent in descriptions of cases in immunocompetent patients. e onset in adulthood is more prevalent, nevertheless, the mean age of presentation is 65 years [6,12] Clinical presentation is variable.…”

Section: Discussionmentioning

confidence: 99%

“…[ 4 , 6 ] The presence of isolated fourth ventricle lesion is rare, with only eight cases previously reported [ Table 1 ]. [ 1 , 3 , 7 - 11 , 13 ] The first report was dated 1977 by Werneck et al . [ 13 ]…”

Section: Discussionmentioning

confidence: 99%

“…[6] ere have been few reports of localized isolated lymphoma developing in the fourth ventricle, with only eight previous cases described. [1,3,[7][8][9][10][11]13]…”

Section: Introductionmentioning

confidence: 99%

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Immunocompetent patient with isolated primary fourth ventricle lymphoma. Unusual diagnosis, their pitfalls, and challenges

Holanda

Pimentel²,

Gosch

et al. 2022

Surgical Neurology International

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Background: Primary central nervous system lymphoma (PCNSL) is an uncommon lesion and represent 4% of all central nervous system (CNS) cancers. There have been few reports of localized isolated lymphoma developing in the fourth ventricle, with only 8 previous cases described. We present a case of an immunocompetent patient with isolated fourth ventricle lymphoma who did not have diffusion-weighted imaging (DWI) restriction. Case Description: A 45-year-old man presented a history of headache, vomiting and weigh loss. Upon clinical examination, he presented bilateral papilledema, multidirectional nystagmus, and gait imbalance. Magnetic resonance imaging showed a solid tumor in fourth ventricle with 1.8 × 1.6 × 1.1 cm. The patient was submitted to a suboccipital telovelar approach. The pathological study showed a neoplasm composed of loose round cells. Immunohistochemistry showed positivity for CD-45 and CD-23. The diagnosis of primary CNS lymphoma of the fourth ventricle was certified. Patient was sent to complementary treatment with hematologist and radiotherapy and chemotherapy were started. Conclusion: PCNSL is a rare and aggressive pathology with high rates of mortality and recurrence. It requires a multidisciplinary team and multiple therapies to control the disease and deliver better quality of life and prognosis to the patient.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Immunocompetent patient with isolated primary fourth ventricle lymphoma. Unusual diagnosis, their pitfalls, and challenges

Holanda

Pimentel²,

Gosch

et al. 2022

Surgical Neurology International

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“…However, this advantage was lost when controlling for the total number of lesions [35]. Of patients with 4 th ventricular PCNSL, 35.3% of patients received ITC [8–11, 14, 16], and 52.9% of patients with 4 th ventricular PCNSL had gross subtotal or total resection [8, 11–17, 22]. These patients also received various combinations of chemotherapy and chemoradiation so whether either of these treatment modalities conferred a survival benefit in this select patient population is not known.…”

Section: Discussionmentioning

confidence: 99%

Primary CNS Lymphoma Arising from the 4^th Ventricle: A Case Report and Review of the Literature

Brozovich

Ewing

Burns

et al. 2019

Case Reports in Oncological Medicine

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A 65-year-old male with a history of ischemic strokes, seizures, and subarachnoid hemorrhage presented with a 4-week history of progressive diplopia, vertigo, nausea, and vomiting. Magnetic resonance imaging (MRI) revealed a 2.5×1.8×1.7 cm posterior fossa mass arising from the roof of the 4th ventricle extending into the cerebellar vermis. Posterior fossa craniotomy with stereotactic biopsy confirmed a locally invasive diffuse large B-cell lymphoma (DLBCL). Primary central nervous system lymphoma (PCNSL) arising from the 4th ventricle is a rare extranodal manifestation of non-Hodgkin lymphoma (NHL), with few cases documented in the literature. Review of available cases lends support that lymphoma arising from the 4th ventricle has a variable clinical presentation, occurs most commonly in immunocompetent males, and should be on the differential of any immunocompetent adult presenting with a posterior fossa mass. Optimal treatment modalities are based largely on phase 2 clinical trials, and recommended guidelines regardless of anatomic location should be adhered to.

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“…PCNSLs within fourth ventricle are relatively seldom seen in immune-competent patients. To the best of our knowledge, only nine cases of PCNSL located at fourth ventricle have been reported in the literature (Table 1) [1][2][3][4][5][6][7][8][9].…”

Section: Discussionmentioning

confidence: 99%

Primary Central Nervous System Lymphoma in the Fourth Ventricle

Xinyi¹,

Qiu²,

Rong³

et al. 2017

J Neuroinfect Dis

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Primary central nervous system lymphoma (PCNSL), a highly malignant and infrequent tumor, is rarely found within the fourth ventricle. Here we report a case of isolated lymphoma within the fourth ventricle: a 61-year-old male presented with headache, mental disorder, abnormal gait and urinary incontinence. Based on the clinical symptoms and neuroimage, He was initially diagnosed as choroid plexus papilloma. However, post-surgery pathology corrected the diagnosis as a diffuse large B-cell lymphoma. To the best of our knowledge, only nine cases are documented in the literature and all of them were initially diagnosed as other tumours or not determined. Therefore, Thesis unconventional location and atypical clinical manifestation of PCNSL in the fourth ventricle should be included on the list of differential diagnosis of the fourth ventricle tumors. Case ReportA 61-year-old man presented to our hospital complaining of headache for one month and somnolence, abnormal gait and urinary incontinence for one week. During admission, he was in a state of somnolence and physical examination only revealed the mild cervical resistance. His past medical history and laboratory tests including routine blood parameters, blood biochemistry (including lactate dehydrogenase (LDH) HIV testing), routine coagulation parameters and erythrocyte sedimentation rate were normal as well.Brain magnetic resonance imaging (MRI) revealed one irregular nodule occupying the fourth ventricle with a hypo intensity on T1 weighted image (T1WI) and is intensity on T2 weighted image (T2WI) (Figure 1). Post-contrast T1WI showed well-defined and marked homogenous enhancement without necrosis. Furthermore, contrast enhancement image demonstrated that the primary nidus of the mass originated from the roof of the forth ventricle, which was surrounded with choroid plexus (Figure 2). The intraventricular location of the mass and MRI manifestation led us to clinical diagnosis as choroid plexus papilloma (CPP). PET-CT of the whole body showed high metabolism in the fourth ventricle. The special location of the mass prompted our surgical team to choose surgical excision over stereotactic biopsy.Interestingly, post-surgery pathology diagnosed as a diffuse large Bcell lymphoma (Figure 3). The patient refused to undergo radiotherapy or chemotherapy immediately after the surgery. At 6-week follow-up after the resection, brain MRI demonstrated enhanced nodules in the third ventricle and midbrain aqueduct area, which were considered as implantation metastases. Consequently, the patient was administrated with chemotherapy combined with radiotherapy. Another month later, these lesions amazingly disappeared on brain MRI. Currently, 20 months post-surgery, the patient is still under active follow-up.

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Primary fourth ventricular B-cell lymphoma in an immunocompetent patient

Abstract: Letter to the Editor.

Cited by 7 publications

References 11 publications

Immunocompetent patient with isolated primary fourth ventricle lymphoma. Unusual diagnosis, their pitfalls, and challenges

Immunocompetent patient with isolated primary fourth ventricle lymphoma. Unusual diagnosis, their pitfalls, and challenges

Primary CNS Lymphoma Arising from the 4^th Ventricle: A Case Report and Review of the Literature

Primary Central Nervous System Lymphoma in the Fourth Ventricle

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Primary fourth ventricular B-cell lymphoma in an immunocompetent patient

Abstract: Letter to the Editor.

Cited by 7 publications

References 11 publications

Immunocompetent patient with isolated primary fourth ventricle lymphoma. Unusual diagnosis, their pitfalls, and challenges

Immunocompetent patient with isolated primary fourth ventricle lymphoma. Unusual diagnosis, their pitfalls, and challenges

Primary CNS Lymphoma Arising from the 4th Ventricle: A Case Report and Review of the Literature

Primary Central Nervous System Lymphoma in the Fourth Ventricle

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Product

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Primary CNS Lymphoma Arising from the 4^th Ventricle: A Case Report and Review of the Literature