Primary leptomeningeal lymphoma with oculomotor paralysis as the initial presentation

[Rinshō ketsueki] The Japanese journal of clinical hematology
Keita OgawaYoshio Suzuki

Abstract

An 85-year-old man presented with right eye ptosis and visual abnormalities. Due to a lack of abnormal findings on plain magnetic resonance imaging (MRI) and laboratory examination, prednisolone therapy was initiated, and ocular myasthenia gravis and ocular symptoms subjectively improved. However, anorexia and conscious disorder appeared during the same period, and he was hospitalized for scrutiny. After admission, left eye adduction disorder and bilateral abduction nerve paralysis were also observed. Enhanced MRI revealed cranial nerve and leptomeninx enhancement. Subsequently, the patient developed seizures and died on the 10th day of hospitalization without being diagnosed. An autopsy revealed infiltration of B-cell lymphoma cells into the subarachnoid space, particularly in the parietal lobe. Similar infiltration was observed in the cerebellum, brainstem, spinal cord, and bilateral oculomotor nerve. Primary leptomeningeal lymphoma is a rare form of primary central nervous system lymphoma without simultaneous parenchymal brain lesions. Clinicians should be aware of this form of lymphoma and carefully monitor its possible occurrence, even when patients are already being treated for other neurological diseases.

Related Concepts

Related Feeds

Anorexia Nervosa

Anorexia nervosa (AN) is a psychiatric condition characterized by severe weight loss and secondary problems associated with malnutrition. Here is the latest research on AN.

CNS Lymphoma

In CNS lymphoma, cancerous cells from lymph tissues or other parts of the body form tumors in the brain and/or spinal cord. Here is the latest research on this rare non-Hodgkin lymphoma.

Related Papers

British Journal of Haematology
Matthew R WilsonMike Leach
Journal of Computer Assisted Tomography
Y KajiyaN Miyaji
Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia
Hiromasa SatoKayoko Higuchi
Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology
Manuel CappellariMaria Donata Benedetti
© 2021 Meta ULC. All rights reserved