1/235. Epstein-Barr virus meningoencephalitis with a lymphoma-like response in an immunocompetent host.We report the clinical and neuropathological findings in an immunocompetent 19-year-old patient with a fatal acute Epstein-Barr virus (EBV) meningoencephalitis and a lymphoma-like B-lymphocyte response. Our results suggest that an immunotoxic rather than direct viral neuronal invasion mediates brain damage in EBV encephalitis and rule out primary central nervous system lymphoma (PCNSL) in our patient. We discuss immunosuppression as a therapeutic option, because present strategies mainly consist of symptomatic therapy due to unclear pathogenesis and nonavailability of effective antiviral agents.- - - - - - - - - - ranking = 1keywords = central nervous system, nervous system, brain (Clic here for more details about this article) |
2/235. Successful therapy with methotrexate of a multicentric mixed lymphoma of the central nervous system.Primary lymphoma of the central nervous system (CNS) is extremely rare. A case of mixed histiocytic lymphocytic lymphoma of the CNS that initially occurred in the spinal cord is reported. Multicentric recurrence following radiotherapy was successfully treated with intrathecal methotrexate and the patient remains free of disease after 4 years. The role of intrathecal methotrexate as alternative therapy following irradiation failure is discussed.- - - - - - - - - - ranking = 4.8445679330082keywords = central nervous system, nervous system (Clic here for more details about this article) |
3/235. Spontaneous remission of primary central nervous system lymphoma: report of 3 cases and discussion of pathophysiology.Primary central nervous system lymphoma (PCNSL) is a relatively uncommon disease in which spontaneous remission is exceedingly rare. We are reporting three cases of primary CNS lymphoma with spontaneous regression in two to eight weeks, from the time of the initial diagnosis. The remission lasted for four years in the first case, two years in the second, and one year in the third case. Tissue diagnosis was made in the first two cases after relapse, and in the third case a biopsy was done at the initial presentation. The literature and the possible pathophysiological mechanisms of this interesting phenomenon are discussed.- - - - - - - - - - ranking = 4.8445679330082keywords = central nervous system, nervous system (Clic here for more details about this article) |
4/235. Primary central nervous system lymphoma presenting with a parkinsonian syndrome of pure akinesia.The incidence of primary central nervous system lymphoma (PCNSL), once a rare tumour, has risen significantly in both immunocompetent and immunosuppressed patients. Although infiltration of the basal ganglia is not uncommon in PCNSL, extrapyramidal movement disorders are generally not recognised as a mode of clinical presentation of this type of cerebral tumour. We present the unusual case of a 75-year-old man who developed a parkinsonian syndrome of "pure akinesia" due to autopsy-confirmed PCNSL primarily involving the globus pallidus bilaterally. Parkinsonism due to bilateral pallidal lesions is known but rare, and such cases help in the understanding of basal ganglia function with regard to akinesia and freezing.- - - - - - - - - - ranking = 4.8445679330082keywords = central nervous system, nervous system (Clic here for more details about this article) |
5/235. Hematologic neoplasia and the central nervous system.central nervous system (CNS) involvement with malignant cells is a well recognized complication of hematologic neoplasms. A number of disorders such as acute lymphoblastic leukemia and high grade lymphoma frequently involve the CNS and prophylactic therapy is advised. Disorders such as acute myeloid leukemia (AML) and multiple myeloma are less likely to be associated with CNS involvement. This series describes three cases of CNS involvement by malignant hematologic disease: myelomatous meningitis, CNS chloromas complicating AML, and primary lymphomatous meningitis.- - - - - - - - - - ranking = 4.1004012854859keywords = central nervous system, nervous system (Clic here for more details about this article) |
6/235. brain damage after intrathecal methotrexate.Ten brains from leukaemic patients given intrathecal methotrexate and 10 from leukaemic patients without intrathecal therapy have been examined. Three of the methodtrexate treated patients appear to have died from their therapy. The histological changes consisted of destruction of oligodendrocytes, sometimes complete over large areas, and sometimes relatively slight. All the patients who survived long enough after treatment showed severe astrocytosis.- - - - - - - - - - ranking = 0.031086413398357keywords = brain (Clic here for more details about this article) |
7/235. Intravascular lymphomatosis. A report of ten patients with central nervous system involvement and a review of the disease process.The clinical, radiographic, and pathological findings in ten cases of intravascular lymphomatosis with central nervous system involvement seen at our institution over a 15-year period are presented. Nine patients presented with a subacute, progressive multifocal neurologic disorder. Most patients had fever, anemia, and elevation of the erythrocyte sedimentation rate. As the illness evolved, computerized tomography scanning and magnetic resonance imaging showed evidence of multifocal central nervous system disease. angiography was nondiagnostic but suggested vasculitis in six cases. A response to empiric corticosteroid treatment was typical but usually transient. In six patients, the diagnosis was made antemortem by brain biopsy. The prognosis of patients was primarily dependent on early diagnosis and treatment, before massive central nervous system damage occurred. Treatment with chemotherapy, with or without radiotherapy, was associated with stabilization of the disease in three of five patients.- - - - - - - - - - ranking = 6.8134815196099keywords = central nervous system, nervous system, brain (Clic here for more details about this article) |
8/235. Solitary sciatic nerve lymphoma as an initial manifestation of diffuse neurolymphomatosis. Case report and review of the literature.Solitary peripheral nerve lymphomas are exceedingly rare primary manifestations of diffuse peripheral nervous system or central nervous system (CNS) lymphomatosis. A 52-year-old man presented with progressive weakness in gastrocnemius and anterior tibial muscle function, which was associated with radiating pain in the right leg. magnetic resonance imaging studies revealed a solitary fusiform tumor, extending from the sciatic nerve, at the level of the lesser trochanter of the femur, into the posterior tibial nerve below the popliteal fossa. Intraoperative gross examination found that the tumor diffusely expanded the nerve, but did not extend from or into surrounding muscle or tendons. The final histological diagnosis was a solitary extranodal lymphoma (Burkittlike high-grade B-cell lymphoma). Postoperative staging did not reveal evidence of lymphomatous involvement of other organs, but additional chemo- and radiotherapies were administered. Four months after the surgical biopsy, the patient presented with a right facial nerve palsy. The results of cytological examination of cerebrospinal fluid were positive for the presence of atypical lymphocytes, which was consistent with apparently progressive neurolymphomatosis; however, the results of radiological studies were negative for systemic progression. The patient underwent intrathecal chemotherapy followed by systemic myelosuppressive chemotherapy with bone marrow rescue, but died of respiratory failure while still receiving treatment. Postmortem examination revealed extensive lymphomatosis in the peripheral nerves and spinal nerve roots without evidence of cranial nerve, CNS, or other organ system involvement. The aggressive biological characteristics of these tumors, their management, and pertinent literature are reviewed.- - - - - - - - - - ranking = 1.193660525681keywords = central nervous system, nervous system (Clic here for more details about this article) |
9/235. Primary malignant lymphoma of the central nervous system presenting with ascites and pleural effusion.A 70-year-old woman was admitted to our hospital owing to ascites and pleural effusion. Though malignant cells (B-cell type lymphoma) were detected in both the ascites and pleural effusion, neither lymph node swelling nor a tumor was detected upon chest, abdominal and pelvic computed tomography (CT). After weekly THP-COP therapy for 8 weeks, the ascites and pleural effusion completely disappeared. Two years after the first admission, she was re-admitted because of a disturbance of consciousness, and a brain tumor was detected on CT scan. The immunohistological and genetic data for the brain tumor were identical to those of the malignant cells in the pleural effusion and ascites detected 2 years previously. Whereas the symptoms at onset of a primary lymphoma of the central nervous system (CNS) are usually neurological ones, in this rare case of primary CNS lymphoma, the symptoms at onset were the ascites and pleural effusion without neurological symptoms.- - - - - - - - - - ranking = 4.9067407598049keywords = central nervous system, nervous system, brain (Clic here for more details about this article) |
10/235. magnetic resonance imaging findings in a patient with bilateral facial paralysis due to malignant lymphoma.In malignant lymphomas, especially non-Hodgkin's lymphomas, invasion to the central nervous system (CNS) often occurs. A patient is reported here with bilateral facial paralysis due to invasion of a malignant lymphoma to the CNS. Contrast magnetic resonance imaging (MRI) revealed swelling of the entire length internal auditory meatus and enhancement in the entire length of the facial nerve. transcranial magnetic stimulation and MRI revealed that later facial nerve injury was present before the onset of paralysis due to a malignant lymphoma. Therefore treatment should be performed with consideration given to the possible invasion of the tumor to the CNS.- - - - - - - - - - ranking = 0.96891358660164keywords = central nervous system, nervous system (Clic here for more details about this article) |
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