A 52-year-old man with large cell non-Hodgkin's lymphoma developed a unique pattern of central nervous system involvement by lymphoma while in apparent systemic remission. Despite intermittent neurological episodes suggestive of CNS involvement by lymphoma no evidence of CNS lymphoma was found on repeated cerebrospinal fluid and brain CT scan examinations. At necropsy widespread occlusion of cerebral blood vessels by malignant lymphoid cells was observed with extensive tissue necrosis and haemorrhages. Leukaemic involvement of peripheral blood was not detected on repeated blood film examinations during life.
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