Apr 10, 2007

Progressive multifocal leukoencephalopathy in a lymphoma patient with complete remission after treatment with cytostatics and rituximab: case report and review of the literature

Clinical Neuropathology
S G Freim WahlS H Torp

Abstract

A 44-year-old woman presented with dysarthria, visual disturbances, ataxia and cognitive impairment. There was a rapid progression of her neurological disease, and she died 8 months later. She was previously treated for a low-grade follicular B-cell lymphoma; complete remission was achieved by conventional radiotherapy and chemotherapy, including rituximab. Two years later, the neurological symptoms and signs started. MRI revealed a cerebral demyelinating process. Serology was negative. Autopsy disclosed areas in cerebral white matter with grey discoloration. Microscopy revealed demyelination, oligodendroglial viral inclusions and gliosis with bizarre astrocytes. Polymerase chain reaction (PCR) was positive for JC virus. These findings were consistent with progressive multifocal leukoencephalopathy (PML). This is one of recent reports on PML occurring in a patient treated with the anti-20 monoclonal antibody rituximab.

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Mentioned in this Paper

Monoclonal Antibodies
Antineoplastic Agents
Leukoencephalopathy, Progressive Multifocal
Ataxia as Late Effect of Cerebrovascular Disease
Autopsy
Brain
Astrocytes
Entire Cerebral White Matter
Cytostatic Agents
Polychemotherapy

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