Cancer Res Treat.  2013 Sep;45(3):234-238.

A Rare Presentation of Follicular Lymphoma: Cerebellar Involvement, Successfully Treated with a Combination of Radiotherapy and Chemotherapy

Affiliations
  • 1Department of Medical Oncology, Gulhane School of Medicine, Ankara, Turkey. drnkaradurmus@yahoo.com
  • 2Department of Internal Medicine, Gulhane School of Medicine, Ankara, Turkey.
  • 3Department of Nuclear Medicine, Gulhane School of Medicine, Ankara, Turkey.
  • 4Department of Pathology, Gulhane School of Medicine, Ankara, Turkey.

Abstract

The central nervous system (CNS) is an important area of involvement for both high-grade, aggressive primary and secondary lymphomas. Although follicular lymphoma represents a low-grade histology, it may rarely present with CNS involvement. Here, we describe a patient diagnosed with follicular lymphoma who was presented with cerebellar involvement.

Keyword

Low-grade; Indolent; Non-Hodgkin lymphoma; Follicular; Involvement; Central nervous system; Cerebellum

MeSH Terms

Central Nervous System
Cerebellum
Humans
Lymphoma
Lymphoma, Follicular
Lymphoma, Non-Hodgkin

Figure

  • Fig. 1 (A) Form and structure that eliminates the normal pattern of lymph node in folliculary lymphoma (H&E staining, ×40). (B) CD-20 positivity in the follicle (×40). (C) Bcl-2 positivity in the follicle center (×40).

  • Fig. 2 (A) F-18 fluorodeoxyglucose-positron emission tomography/computed tomography (F-18 FDG-PET/CT) showing a right cerebellar diffuse intensity with high maximum standardized uptake value (SUV max) levels of 11.3. (B) F-18 FDG-PET/CT showing aleft supraclavicular lymph nodes with high SUV max levels of 12.3. (C) The brain magnetic resonance imaging showing a homogen-contrasted lesion, with a maximum 1.5 cm diameter and isointence appearence to gray mater, involving dural surface totally on posterior, inferior, and lateral regions of the right cerebellum.


Reference

1. Hollender A, Kvaloy S, Lote K, Nome O, Holte H. Prognostic factors in 140 adult patients with non-Hodgkin's lymphoma with systemic central nervous system (CNS) involvement: a single centre analysis. Eur J Cancer. 2000; 36:1762–1768. PMID: 10974623.
Article
2. Edge SB, Byrd DR, Compton CC, Fritz AG, Greene FL, Trotti A. AJCC cancer staging handbook. 7th ed. New York: Springer;2010.
3. Eisenhauer EA, Therasse P, Bogaerts J, Schwartz LH, Sargent D, Ford R, et al. New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1). Eur J Cancer. 2009; 45:228–247. PMID: 19097774.
Article
4. Kleinschmidt-DeMasters BK, Gilden DH. The expanding spectrum of herpesvirus infections of the nervous system. Brain Pathol. 2001; 11:440–451. PMID: 11556690.
5. Grupka NL, Seinfeld J, Ryder J, Lillehei KO, Kleinschmidt-Demasters BK. Secondary central nervous system involvement by follicular lymphoma: case report and review of the literature. Surg Neurol. 2006; 65:590–594. PMID: 16720183.
Article
6. Kumar S, Kumar D, Kaldjian EP, Bauserman S, Raffeld M, Jaffe ES. Primary low-grade B-cell lymphoma of the dura: a mucosa associated lymphoid tissue-type lymphoma. Am J Surg Pathol. 1997; 21:81–87. PMID: 8990144.
7. Beriwal S, Hou JS, Miyamoto C, Garcia-Young JA. Primary dural low grade BCL-2 negative follicular lymphoma: a case report. J Neurooncol. 2003; 61:23–25. PMID: 12587792.
8. Low I, Allen J. Low-grade follicular lymphoma in the dura: rare mimic of meningioma. Neuropathology. 2006; 26:564–568. PMID: 17203594.
Article
9. Hamilton DK, Bourne TD, Ahmed H, Cousar JB, Mandell JW, Sheehan JP. Follicular lymphoma of the dura: case report. Neurosurgery. 2006; 59:E703–E704. PMID: 16955025.
10. Riccioni L, Morigi F, Cremonini AM. Follicular lymphoma of the dura associated with meningioma: a case report and review of the literature. Neuropathology. 2007; 27:278–283. PMID: 17645243.
Article
11. MacKintosh FR, Colby TV, Podolsky WJ, Burke JS, Hoppe RT, Rosenfelt FP, et al. Central nervous system involvement in non-Hodgkin's lymphoma: an analysis of 105 cases. Cancer. 1982; 49:586–595. PMID: 7059915.
Article
12. Hoerni-Simon G, Suchaud JP, Eghbali H, Coindre JM, Hoerni B. Secondary involvement of the central nervous system in malignant non-Hodgkin's lymphoma: a study of 30 cases in a series of 498 patients. Oncology. 1987; 44:98–101. PMID: 3574856.
13. Tomita N, Kodama F, Sakai R, Koharasawa H, Hattori M, Taguchi J, et al. Predictive factors for central nervous system involvement in non-Hodgkin's lymphoma: significance of very high serum LDH concentrations. Leuk Lymphoma. 2000; 38:335–343. PMID: 10830740.
Article
14. Jellinger K, Radiaszkiewicz T. Involvement of the central nervous system in malignant lymphomas. Virchows Arch A Pathol Anat Histol. 1976; 370:345–362. PMID: 826017.
Article
15. Spectre G, Gural A, Amir G, Lossos A, Siegal T, Paltiel O. Central nervous system involvement in indolent lymphomas. Ann Oncol. 2005; 16:450–454. PMID: 15642707.
Article
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