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CASE REPORT
Lymphomatosis cerebri: diagnostic challenges and review of the literature
  1. Paul J Lee1,
  2. Idanis Berrios2,
  3. Carolina Ionete3,
  4. Thomas Smith4
  1. 1Department of Pathology, UMass Memorial Medical Center University Campus, Worcester, Massachusetts, USA
  2. 2Department of Neurology, University of Massachusetts School of Medicine, Worcester, Massachusetts, USA
  3. 3University of Massachusetts, Worcester, Massachusetts, USA
  4. 4Department of Pathology, University of Massachusetts, Worcester, Massachusetts, USA
  1. Correspondence to Dr Idanis Berrios, idanis.berrios{at}gmail.com

Summary

Lymphomatosis cerebri (LC) is a rare variant of a primary central nervous system non-Hodgkin's lymphoma (PCNSL) characterised by diffuse infiltration of tumour cells throughout the brain parenchyma. We present a 68-year-old immunocompetent woman with headaches, dizziness, blurred vision, localised right leg weakness and rapidly progressive dementia. A brain MRI demonstrated diffuse T2 hyperintense white matter lesions that did not enhance with contrast. The clinical differential diagnosis of these lesions included metastatic disease, infectious or inflammatory process such as sarcoidosis, lymphoma, demyelinating disease and less likely vascular aetiology, such as vasculitis or ischaemic stroke. A right frontal stereotactic brain biopsy was non-diagnostic. The patient eventually died from aspiration pneumonia following a pneumonectomy for a primary lung adenocarcinoma. The diagnosis of LC was established on postmortem examination of the brain.

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Footnotes

  • Contributors PJL contributed in writing, intellectual input, interpreting data and reviewing this study. IB contributed in writing, intellectual input, interpreting data and reviewing this study. CI contributed in intellectual input, analysis and data interpretation and reviewing of this study. TS contributed in intellectual input, analysis and data interpretation and reviewing of this study.

  • Competing interests None declared.

  • Patient consent Obtained.

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

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