title: Leptomeningeal involvement in B-cell chronic lymphocytic leukemia: a case report and review of the literature.
abstract: BACKGROUND
  Central nervous system involvement is considered a rare complication of chronic lymphocytic leukemia, and so there is the risk of being overlooked.
  
  
  METHODS
  We report a case of central nervous system involvement in a 75-year-old mulatto woman with chronic lymphocytic leukemia after 5 years of follow-up and a literature review on the subject. The clinical course, treatment and outcome are described. A systematic, meticulous and comprehensive analysis of existing publications regarding chronic lymphocytic leukemia with central nervous system involvement was performed.
  
  
  CONCLUSIONS
  We concluded that central nervous system involvement of chronic lymphocytic leukemia is probably not associated with any evident risk factors. Diagnostic approach differs by institutions but often includes imaging, morphology and flow cytometry. Resolution of central nervous system symptoms can usually be accomplished with intrathecal chemotherapy or irradiation followed by systemic treatment. The recognition of this entity by clinicians could lead to early detection and treatment, resulting in better outcomes in this rare complication.
authors.forename: Simone Lima
authors.initials: SL
authors.lastname: de Souza
authors.forename: Fábio
authors.initials: F
authors.lastname: Santiago
authors.forename: Marilza de Moura
authors.initials: Mde M
authors.lastname: Ribeiro-Carvalho
authors.forename: Adriano
authors.initials: A
authors.lastname: Arnóbio
authors.forename: Andréa Ribeiro
authors.initials: AR
authors.lastname: Soares
authors.affiliation: Departamento de Patologia, Faculdade de Ciências Medicas, Programa de Pós Graduação em Ciências Médicas, Universidade do Estado do Rio de Janeiro, 444/4° andar, Vila Isabel, Rio de Janeiro, Brazil. mariahelenaornellas@gmail.com.
authors.forename: Maria Helena
authors.initials: MH
authors.lastname: Ornellas
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000473:pathology*; D008297:Male; D008577:Meningeal Neoplasms / Q000556:secondary*; D008875:Middle Aged