Leptomeningeal infiltlation of primary CNS B-cell lymphoma diagnosed by the biopsy of cauda equina: a case report

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  • Nakajima Hideki
    Unit of Translational Medicine, Department of Clinical Neuroscience and Neurology, Nagasaki University Graduate School of Biomedical Science
  • Motomura Masakatsu
    Unit of Translational Medicine, Department of Clinical Neuroscience and Neurology, Nagasaki University Graduate School of Biomedical Science
  • Yamaguchi Masashi
    Department of Clinical Neurosurgery, Nagasaki University Graduate School of Biomedical Sciences
  • Katoh Takeharu
    Department of Clinical Hematology, Nagasaki University Graduate School of Biomedical Sciences
  • Abe Kuniko
    Department of Clinical Pathology, Nagasaki University Graduate School of Biomedical Sciences

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Other Title
  • 馬尾生検が診断に有用であった髄膜播種性の悪性リンパ腫の1例
  • 症例報告 馬尾生検が診断に有用であった髄膜播種性の悪性リンパ腫の1例
  • ショウレイ ホウコク バ ビセイケン ガ シンダン ニ ユウヨウ デ アッタ ズイマク ハシュセイ ノ アクセイ リンパシュ ノ 1レイ

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Abstract

A 49-year-old man was admitted to our hospital with progressive gait disturbance. Our examination revealed a low grade fever, weight loss derived muscle weakness, sensory disturbance and loss of deep tendon reflex of the lower extremities. Magnetic resonance imaging (MRI) detected an abnormal intensity and gadolinium enhancement in the cauda equina. Two weeks after admission, disturbance of consciousness and bladder appeared. Cerebrospinal fluid examination showed pleocytosis, elevated protein and soluble IL-2R, but cytological examination was class II negative. We performed a cauda equina biopsy urgently and diagnosed malignant lymphoma, of a diffuse large B-cell type. We selected combined MTX-based chemoradiotherapy and his symptoms significantly improved after a month. He achieved complete remission and remains recurrence-free after 10 months post treatment although he remains with light paraparesis and sensory disturbance of the lower extremities. He has already gone back to a normal life. An examination of cauda equina biopsy led to quick diagnosis and treatment.

Journal

  • Rinsho Shinkeigaku

    Rinsho Shinkeigaku 53 (10), 803-808, 2013

    Societas Neurologica Japonica

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