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Case report
Use of rituximab in lymphomatoid granulomatosis with isolated central nervous system involvement
  1. Jesse Mooneyham1,
  2. Cesar Gentille2,
  3. Andrea Barbieri3 and
  4. Shilpan Shah2
  1. 1Texas A&M Health Science Center College of Medicine, Houston, Texas, USA
  2. 2Houston Methodist Cancer Center, Houston, Texas, USA
  3. 3Department of Hematopathology, Houston Methodist Hospital, Houston, Texas, USA
  1. Correspondence to Dr Cesar Gentille; cgentillesanchez{at}


A 33-year-old woman presented to the emergency room with severe headaches. A CT scan of the head revealed two brain lesions with associated vasogenic oedema. Diagnostic resection of one of the lesions followed by pathological analysis revealed grade III lymphomatoid granulomatosis (LYG). Staging investigations elsewhere in the body were negative, isolating this case of LYG to the central nervous system, an atypical presentation. After the resection, she was treated with single-agent rituximab 375 mg/m2. The follow-up MRI demonstrated the resolution of brain lesions and no progression of the disease.

  • haematology (drugs and medicines)
  • malignant disease and immunosuppression
  • malignant and benign haematology
  • neurooncology
  • neurosurgery

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  • Contributors JM performed review of the literature, as well as contributed to the writing of the manuscript. CGS analysed and interpreted patient information, reviewed literature and edited the writing of the manuscript. AB performed histological evaluation of the CNS-LYG lesion, provided the histological slides found in the manuscript as well as the descriptions. SS was the primary physician for the case presented. He edited the final manuscript. All authors have reviewed and approved of the final manuscript for submission.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.