Case report of unusual leukoencephalopathy preceding primary CNS lymphoma
- aMemorial Sloan-Kettering Cancer Center, New York, New York, USA, bMassachusetts General Hospital, Boston, Massachusetts, USA
- Dr Keith Brecher, Memorial Sloan-Kettering Cancer Center, Department of Neurology, 1275 York Avenue, New York, New York 10021, USA. Telephone 001 212 639 7047; fax 001 212 717 3551; email brecherk{at}mskcc.org
- Received 17 October 1997
- Revised 27 January 1998
- Accepted 30 January 1998
Abstract
A previously healthy 35 year old woman presented with bilateral uveitus associated with multiple, evolving, non-enhancing white matter lesions consistent with a progressive leukoencephalopathy such as multiple sclerosis. Thirty months after her initial presentation, she was diagnosed with primary CNS lymphoma and died 14 months later. The unusual clinical course preceding the diagnosis suggests that a demyelinating disease may have preceded, and possibly heralded, the development of primary CNS lymphoma. Cases of “sentinel lesions” heralding the diagnosis of primary CNS lymphoma have been reported, and this case further corroborates such instances and raises further issues regarding possible neoplastic transformation occurring in inflammatory diseases such as multiple sclerosis.
