title: Leptomeningeal involvement in a patient with splenic lymphoma with villous lymphocytes.
abstract: Splenic lymphoma with villous lymphocytes (SLVL) is an indolent hematological malignancy. Persistent lymphocytosis and splenomegaly usually last for years before patients develop infectious complications. Organ involvement other than spleen and bone marrow is rare in SLVL. We report a case of SLVL-related meningitis occurring in a patient presenting with altered mental status and seizures. CNS involvement was documented by an MRI of the head and by the presence of atypical lymphocytes in the cerebrospinal fluid (CSF). Morphologic examination and immunophenotypic analyses were conducted to determine the nature of atypical lymphocytes in the peripheral blood, spleen, bone marrow and CSF. The patient improved after treatment with a combination of radiation and chemotherapy.
authors.affiliation: Division of Hematology/Oncology, The Brooklyn Hospital Center, New York 11201, USA. vzgotlib@aol.com
authors.forename: Vladimir
authors.initials: V
authors.lastname: Gotlib
authors.forename: Sanjay
authors.initials: S
authors.lastname: Singareddy
authors.forename: Usam
authors.initials: U
authors.lastname: Gergis
authors.forename: John
authors.initials: J
authors.lastname: Vakios
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Guevara
authors.forename: Amy
authors.initials: A
authors.lastname: Chadburn
authors.forename: Leonid L
authors.initials: LL
authors.lastname: Yavorkovsky
authors.forename: Arun
authors.initials: A
authors.lastname: Patel
authors.forename: Ahmar
authors.initials: A
authors.lastname: Butt
authors.forename: Asha
authors.initials: A
authors.lastname: Nayak
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use; D002555:Cerebrospinal Fluid / Q000166:cytology; D016371:Cranial Irradiation; D003520:Cyclophosphamide / Q000008:administration & dosage; D003907:Dexamethasone / Q000627:therapeutic use; D017707:Erythrocyte Transfusion; D006801:Humans; D008218:Lymphocytosis / Q000209:etiology; D008228:Lymphoma, Non-Hodgkin / Q000134:cerebrospinal fluid / Q000188:drug therapy / Q000473:pathology* / Q000532:radiotherapy; D008279:Magnetic Resonance Imaging; D008297:Male; D008578:Meninges / Q000473:pathology*; D014411:Neoplastic Stem Cells / Q000473:pathology; D011241:Prednisone / Q000008:administration & dosage; D013160:Splenic Neoplasms / Q000134:cerebrospinal fluid / Q000188:drug therapy / Q000473:pathology*; D014750:Vincristine / Q000008:administration & dosage; D014805:Vitamin B 12 / Q000627:therapeutic use; D014806:Vitamin B 12 Deficiency / Q000150:complications / Q000188:drug therapy
chemical_list: D014750:Vincristine; D003907:Dexamethasone; D003520:Cyclophosphamide; D014805:Vitamin B 12; D011241:Prednisone