title: Leptomeningeal plasmacytosis. Case report and considerations on treatment.
abstract: We describe a 68-year-old patient with a plasma cell leukaemia in haematological remission presenting with massive intracranial leptomeningeal plasmocytic infiltration (LPI) and hydrocephalus. He was treated with skull irradiation and a combination of intraventricular and lumbar intrathecal therapy with methotrexate. Neurologic improvement and clearance of plasma cells from the cerebrospinal fluid was reached after 2 weeks of treatment but prolonged follow-up was interrupted by a lethal gastro-intestinal haemorrhage, 6 weeks after starting the therapy. From previously reported cases it is known that LPI almost always occurs in either high-grade plasmocytomas or plasma cell leukaemia. These data suggest that therapy of LPI should be the same as in other leukaemias with leptomeningeal infiltration.
authors.affiliation: Department of Neurology, St Lukasziekenhuis, Amsterdam, The Netherlands.
authors.forename: P R
authors.initials: PR
authors.lastname: Schiphof
authors.forename: J A
authors.initials: JA
authors.lastname: Vanneste
authors.forename: J E
authors.initials: JE
authors.lastname: Ploem
mesh_terms: D000368:Aged; D001932:Brain Neoplasms / Q000532:radiotherapy / Q000556:secondary*; D006801:Humans; D006849:Hydrocephalus / Q000209:etiology; D007952:Leukemia, Plasma Cell; D008297:Male; D010954:Plasmacytoma / Q000532:radiotherapy / Q000556:secondary*