Abstract
Primary central nervous system lymphoma (PCNSL) is one of the least common malignant brain tumors. It is usually diagnosed initially as diffuse large B cell lymphoma (DLBCL). In rare cases, however, a demyelinating lesion referred to as a "sentinel lesion" precedes the actual diagnosis, which usually depicts two distinct patterns of inflammatory cells during histological analysis. This case report describes a unique histological finding and describes the recognized variations in sentinel lesion histopathology. A 78-year-old female patient was found to have multiple white matter lesions of various degrees of enhancement on post-contrast T1-weighted magnetic resonance imaging. A stereotactic biopsy of a heterogeneous lesion in the left occipital lobe was performed, which revealed demyelination along with lymphocytic infiltration, reactive astrocytosis, abundant T cells, and foamy macrophages. There was no evidence of monoclonality, rapid regression of all lesions occurred, and the patient was thus treated for tumefactive demyelination. Three months later, all of the residual lesions had enlarged and were homogeneously enhancing. An endoscopic-guided biopsy of the right periventricular lesion showed diffuse atypical lymphoid cells...Continue Reading
References
Sep 1, 1992·Journal of the Neurological Sciences·Y KurodaH Sugihara
Jan 1, 1996·Journal of Neurology, Neurosurgery, and Psychiatry·L AldersonD N Louis
Feb 13, 2001·Journal of Neurology, Neurosurgery, and Psychiatry·T KuhlmannJ Frahm
Sep 25, 2007·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Steven NgChristopher Rowe
Mar 1, 2009·Therapeutic Advances in Neurological Disorders·Uwe Schlegel
Mar 6, 2012·The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques·Leila HusseiniBernd C Kieseier
Feb 16, 2013·Internal Medicine·Yasuko OheNorio Tanahashi
Jun 17, 2014·Oncology Letters·Junkoh YamamotoShigeru Nishizawa
Oct 13, 2015·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Sarah KalusFrank Gaillard
Jan 3, 2016·World Neurosurgery·Jian-Qiang LuGregg Blevins
May 22, 2016·BMC Neurology·Mark D KvartaRobert K Shin
Mar 21, 2017·Medical Oncology·Semra Paydas
Jun 7, 2018·Diagnostic Pathology·Rodrigo JavierCraig Horbinski
Jul 24, 2018·BioMed Research International·C ChiavazzaR Rudà