Abstract
Primary central nervous system lymphoma (PCNSL) can be confused with multiple sclerosis (MS) in patients who present with neurological dysfunction, a non-enhancing periventricular lesion, and CSF pleocytosis. Administration of corticosteroid causes clinical improvement and regression of PCNSL in some patients which may be interpreted as a steroid-induced remission from an exacerbation of MS. Sustained clinical dependance upon corticosteroid is unusual in MS, and should lead to consideration of PCNSL. Repeat CSF examination and gadolinium-enhanced MRI scan obtained off corticosteroid should differentiate between the two diagnostic possibilities.
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References
Jiddane M, Nicoli F, Diaz P, Bergvall U, Vincentelli F, Hassoun J, Salamon G: Intracranial malignant lymphoma. J Neurosurg 65: 592–599, 1986
Hochberg FH, Miller DC: Primary central nervous system lymphoma. J Neurosurg 68: 835–853, 1988
DeAngelis LD, Yahalom J, Heinemann MH, Cirrincione C, Thaler HT, Krol G: Primary central nervous system lymphoma: Combined treatment with chemotherapy and radiotherapy. Neurology 40: 80–86, 1990
Willoughby EW, Grochowski E, Li DKB, Oger J, Kastrukoff LF, Paty DW: Serial magnetic resonance scanning in multiple sclerosis: A second prospective study in relapsing patients. Ann Neurol 25: 43–49, 1989
Singh A, Strobos RJ, Singh BM, Rothballer AB, Reddy V, Puljk S, Poon TP: Steroid-induced remissions in CNS lymphoma. Neurology 32: 1267–71, 1982
Vaquero J, Martinez R, Rossi E, Lopez R: Primary cerebral lymphoma: the ‘ghost tumor’. J Neurosurg 60: 174–176, 1984
Gametchu B: Glucocorticoid receptor-like antigen in lymphoma cell membranes: Correlation to cell lysis. Science 236: 456–461, 1987
Ruff RL, Petito CK, Rawlinson DG: Primary cerebral lymphoma mimicking multiple sclerosis. Arch Neurol 36: 598, 1979
Schaumburg HH, Plank CR, Adams RD: The reticulum cell sarcoma-microglioma group of brain tumors. Brain 95: 199–212, 1972
Levy DE: Transient CNS deficits: A common, benign syndrome in young adults. Neurology 38: 831–836, 1988
Fazekas F, Chawluk JB, Alavi A, Hurtig HI, Zimmerman RA: MR signal abnormalities at 1.5 T in Alzheimer's dementia and normal aging. Amer J Neuro Radiol 8: 421–426, 1987
Fazekas F, Offenbacher H, Fuchs S, Schmidt R, Niederkorn K, Horner S, Lechner H: Criteria for an increased specificity of MRI interpretation in elderly subjects with suspected multiple sclerosis. Neurology 38: 1822–1825, 1988
Eby NL, Grufferman S, Flannelly CM, Schold SC, Vogel FS, Burger PC: Increasing incidence of primary brain lymphoma in the US. Cancer 62: 2461–2465, 1988
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DeAngelis, L.M. Primary central nervous system lymphoma imitates multiple sclerosis. J Neuro-Oncol 9, 177–181 (1990). https://doi.org/10.1007/BF02427840
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DOI: https://doi.org/10.1007/BF02427840