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- W2143248933 abstract "Lymphomatosis cerebri (LC) is a rare variant of primary central nervous system lymphoma (PCNSL) pathologically characterised by diffuse cerebral infiltration of a non-cohesive mass of malignant lymphoid cells. We describe a case of rapidly progressive dementia where MRI demonstrated a diffuse leukoencephalopathy. After a series of normal investigations, brain biopsy was undertaken with histology consistent with LC. Our patient was successfully treated with chemoradiotherapy and neurorehabilitation. This case underlines the importance of timely brain biopsy in rapidly progressive cognitive decline to allow earlier therapy for potentially curable pathology.A 50-year-old previously fit and well lady with no vascular risk factors presented to her general practitioner with personality change and emotional lability, against a background of subacutely progressive amnestic syndrome over 3 weeks. She next developed severe anxiety and insomnia and was commenced on citalopram and temazepam. Neurological examination demonstrated universally brisk reflexes with no clonus and downgoing plantar responses. There was marked language difficulty with both expressive and receptive components and ideational and ideomotor apraxia. Formal neuropsychometric testing showed marked impairment in memory, naming, literacy skills and information processing speed (all <5th centile) with relative preservation of executive functioning (phonemic fluency 25th–50th centile). Testing was consistent with marked and pervasive cognitive dysfunction affecting mainly posterior, cortical and subcortical regions.Full blood count, C-reactive protein, ESR, renal and liver function tests were normal. EEG showed left temporal irregular slowing with occasional low-voltage sharp waves suggestive of epileptiform activity. MRI examination (figure 1A–C) demonstrated extensive confluent areas of T2-weighted hyperintensity diffusely throughout the cerebrum and brainstem. There was no perceptible mass effect, …" @default.
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- W2143248933 date "2014-05-20" @default.
- W2143248933 modified "2023-09-25" @default.
- W2143248933 title "Lymphomatosis cerebri: a treatable cause of rapidly progressive dementia" @default.
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- W2143248933 doi "https://doi.org/10.1136/jnnp-2013-307327" @default.
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