Herpes simplex encephalitis and subsequent cytomegalovirus encephalitis after chemoradiotherapy for central nervous system lymphoma: a case report and literature review.
Neurological complications during the treatment of hematological malignancies have a wide range of causes. Treatment-related leukoencephalopathy has been recognized as a major complication of combined chemotherapy and radiotherapy for central nervous system (CNS) lymphoma, and can complicate the diagnosis of CNS infection. Herein, we present a patient with diffuse large B-cell lymphoma who developed herpes simplex encephalitis (HSE) and subsequent cytomegalovirus encephalitis after chemoradiotherapy for CNS relapse. Although cerebrospinal fluid examination (CSF) showed no significant pleocytosis, brain magnetic resonance imaging and polymerase chain reaction analysis of the CSF were useful in the diagnosis. With a review of the literature on the association between HSE and radiotherapy for CNS malignancies, our case suggests that an awareness of viral encephalitis is important in the differential diagnosis of acute neurologic disturbance during chemoradiotherapy for CNS lymphoma.
Suzuki
Hiroshi I
HI
Department of Hematology and Oncology, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
Hangaishi
Akira
A
Department of Hematology and Oncology, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
Hosoya
Noriko
N
Department of Hematology and Oncology, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.|Department of Cell Therapy and Transplantation Medicine, University of Tokyo Hospital, Tokyo, Japan.
Watanabe
Takuro
T
Department of Hematology and Oncology, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
Kanda
Yoshinobu
Y
Department of Hematology and Oncology, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
Motokura
Toru
T
Department of Hematology and Oncology, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
Chiba
Shigeru
S
Department of Cell Therapy and Transplantation Medicine, University of Tokyo Hospital, Tokyo, Japan.
Kurokawa
Mineo
M
Department of Hematology and Oncology, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan. kurokawa-tky@umin.ac.jp.
D044466:Asian People; D016543:Central Nervous System Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D003131:Combined Modality Therapy / Q000009:adverse effects; D003586:Cytomegalovirus Infections / Q000209:etiology*; D003937:Diagnosis, Differential; D018792:Encephalitis, Viral / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D006561:Herpes Simplex / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D007564:Japan; D016403:Lymphoma, Large B-Cell, Diffuse / Q000150:complications* / Q000175:diagnosis / Q000628:therapy