Leptomeningeal plasmacytosis. Case report and considerations on treatment.
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.
Schiphof
P R
PR
Department of Neurology, St Lukasziekenhuis, Amsterdam, The Netherlands.
Vanneste
J A
JA
Ploem
J E
JE
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*