title: [Diffuse large B-cell lymphoma occurring in a Waldenström macroglobulinemia patient with central nervous system infiltration].
abstract: The rare central nervous system (CNS) infiltration of Waldenström macroglobulinemia (WM) is known as Bing-Neel syndrome (BNS). Furthermore, the transformation of WM into diffuse large B-cell lymphoma (DLBCL) is also unusual. Herein, we report a 69-year-old male with DLBCL transformed from BNS. In November 2008, the patient visited a prior hospital because of anemia and was diagnosed with WM. After receiving chemotherapy (R-CHOP), his serum immunoglobulin M (IgM) level decreased and then remained at approximately 2000 mg/dl for 3 years. In November 2011, he complained of visual impairment and photophobia in his left eye. Magnetic resonance imaging showed enlargement of the left optic nerve and cerebrospinal fluid examination indicated CNS infiltration of WM cells. Consequently, he was diagnosed with BNS. He thus received CNS targeted chemotherapy (R-MPV) and achieved a partial response. In May 2014, IgM was elevated and swelling of systemic lymph nodes was detected. Inguinal lymph node biopsy yielded a pathological diagnosis of DLBCL and the clonality of tumor cells between WM and DLBCL was confirmed by the allele-specific oligonucleotide polymerase chain reaction (ASO-PCR).
authors.affiliation: Faculty of Medicine, Osaka University.
authors.forename: Yuto
authors.initials: Y
authors.lastname: Hayashi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Sata
authors.forename: Keigo
authors.initials: K
authors.lastname: Akuta
authors.forename: Jun
authors.initials: J
authors.lastname: Toda
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Kusakabe
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Ueda
authors.forename: Yasutaka
authors.initials: Y
authors.lastname: Ueda
authors.forename: Jiro
authors.initials: J
authors.lastname: Fujita
authors.forename: Seiji
authors.initials: S
authors.lastname: Tadokoro
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Maeda
authors.forename: Junichi
authors.initials: J
authors.lastname: Nishimura
authors.forename: Hirohiko
authors.initials: H
authors.lastname: Shibayama
authors.forename: Kenji
authors.initials: K
authors.lastname: Oritani
authors.forename: Yuzuru
authors.initials: Y
authors.lastname: Kanakura
mesh_terms: D000368:Aged; D002490:Central Nervous System / Q000473:pathology*; D015321:Gene Rearrangement; D006801:Humans; D007143:Immunoglobulin Heavy Chains / Q000235:genetics; D008198:Lymph Nodes / Q000473:pathology; D016403:Lymphoma, Large B-Cell, Diffuse / Q000150:complications* / Q000188:drug therapy / Q000235:genetics / Q000473:pathology*; D008297:Male; D008258:Waldenstrom Macroglobulinemia / Q000209:etiology* / Q000235:genetics
chemical_list: D007143:Immunoglobulin Heavy Chains