Prolonged interval between sentinel pseudotumoral demyelination and development of primary CNS lymphoma

Steven Ng, Helmut Butzkueven, Renate Kalnins, Christopher Rowe

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28 Citations (Scopus)

Abstract

Primary central nervous system lymphoma (PCNSL) can be associated with preceding demyelinating pseudotumoral brain lesions. The 'sentinel' demyelinating lesions recede spontaneously or with corticosteroid, and are followed by development of PCNSL typically within 12 months. This report describes a 29 year-old post-partum woman who developed PCNSL 4 years after a biopsy-proven pseudotumoral demyelinating episode. She presented with focal seizures in February 2005. She subsequently developed hemiparesis and raised intracranial pressure. MRI showed two contrast enhancing lesions in the right frontal lobe, which were hypermetabolic on 18 F-FDG PET. A provisional diagnosis of tumefactive multiple sclerosis was made. Symptoms recurred despite multiple courses of high dose corticosteroid. Brain biopsy confirmed large B-cell non-Hodgkin's lymphoma. This patient illustrates the importance of considering PCNSL in patients presenting with a space-occupying lesion, even with previously confirmed demyelination, and that the interval between the two events may be several years.

Original languageEnglish
Pages (from-to)1126-1129
Number of pages4
JournalJournal of Clinical Neuroscience
Volume14
Issue number11
DOIs
Publication statusPublished - 1 Nov 2007

Keywords

  • Demyelination
  • Lymphoma
  • PCNSL
  • Post-partum
  • Pseudotumoral
  • Sentinel

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