Case of the Week
Section Editors: Matylda Machnowska1 and Anvita Pauranik2
1University of Toronto, Toronto, Ontario, Canada
2BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
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July 21, 2014
Lymphomatous Meningitis from Diffuse Large B-Cell Lymphoma (DLBCL)
- Leptomeningeal tumor spread is a complication in up to approximately 5% of all systemic cancers and can result from lymphomatous meningitis.
- Leptomeningeal involvement in all lymphomas is believed to be around 10%.
- Clinical presentation for lymphomatous meningitis is highly variable, as the entire neuroaxis can be affected.
- Key Diagnostic Features: Leptomeningeal enhancement will be seen. Often, there is enhancement seen along the involved (thickened) cranial nerves.
- DDx: Other etiologies of leptomeningeal carcinomatosis, perineural spread of tumor, infectious causes such as meningitis, and conditions such as sarcoidosis
- Rx: Systemic and intrathecal chemotherapy. Radiation therapy typically reserved for bulky, systemic disease.
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