Longterm meningeal involvement as the only clinical manifestation of low grade malignant non-Hodgkin's lymphoma.
We present the case of a 56-year-old man who developed-at the age of 46-paraesthesia and numbness in the perianal region, the feet and lower legs accompanied by the presence of B-lymphocytes in the cerebrospinal fluid (CSF). Despite intensive work-up an explanation was not found until he developed hepato-splenomegaly ten years after the initial symptoms. Haematologic evaluation at that time disclosed a low-grade malignant B-cell lymphoma. Repeated CSF examination revealed 31 leukocytes/mm3, of which were mainly lymphocytes. These proved to be B-lymphocytes of monoclonal origin. These findings suggest that a leptomeningeal localisation of a low-grade malignant lymphoma had been present for ten years before systemic manifestation of the disease.
Heimans
J J
JJ
Department of Neurology, Free University Hospital, Amsterdam, The Netherlands.
Wijermans
P W
PW
Polman
C H
CH
Huijgens
P C
PC
Ossenkoppele
G J
GJ
van Kamp
G J
GJ
D000328:Adult; D001402:B-Lymphocytes / Q000276:immunology; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis / Q000134:cerebrospinal fluid; D008228:Lymphoma, Non-Hodgkin / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000473:pathology; D008297:Male; D008577:Meningeal Neoplasms / Q000134:cerebrospinal fluid / Q000175:diagnosis / Q000556:secondary*
D007074:Immunoglobulin G