Last update:
08-Jul-2009

Central nervous system involvement, a well recognized complication of aggressive non-Hodgkin's lymphoma (NHL), has been rarely reported in indolent lymphomas. The case is reported of a 67 year-old male patient with follicular lymphoma (grade II) who presented with fever, night sweats, generalized lymphadenopathy and bone marrow involvement. Excellent initial clinical regression of the lymphoma was achieved with fludarabin and cyclophosphamide chemotherapy. However, during the fifth cycle of chemotherapy, progressive neurological symptomatology with respiratory depression appeared. A diagnosis of lep tomeningeal lymphoma was made by immunohistochemical analysis of cytospin slides of the cerebrospinal fluid (CSF), with the finding that 90% of CSF mononuclear cells were CD20⁺, kappa⁺, lamda^-. Systemic and intrathecal chemotherapy were ineffective, and ten days later the patient died.

Key words: Cerebrospinal fluid, CNS involvement, Differential diagnosis, Indolent non-Hodgkin's lymphoma, Immunohistochemical analysis.