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A case of malignant lymphoma exhibiting multiple cranial nerve enhancement: leptomeningeal metastasis? Or another lymphoma associated event?
  1. Y TAJIMA,
  1. Sapporo City General Hospital, N11, W13, Chyu-o-ku, Sapporo, 060–8604, Japan
  1. Dr Y Tajima fwkc2023{at}

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The frequency of the involvement of non-Hodgkin's lymphoma in the CNS has been reported to be less than 10%.1-3Moreover, as those patients have often been resistant to both chemotherapy and radiation therapy, their prognosis has been very poor.1-3 We report herein a rare case of malignant lymphoma showing bilateral homogenous and symmetric enhancement of multiple cranial nerves, with the patient's postmortem examination providing controversial pathological findings. A 50 year old woman developed supraclavicular lymph node swelling about 1 year ago, and was diagnosed as having malignant lymphoma (non-Hodgkin's lymphoma, diffuse large B cell type) after pathological examination of the lymph node. She then received systemic chemotherapy and peripheral blood stem cell transplantation. After six courses of CHOP therapy, she achieved complete remission and was discharged. A few weeks later, she gradually lost her appetite and her temperature remained consistently raised above 38°C for several days. One day before readmission, she noticed double vision, dysphagia, and hoarseness. Neurological examination demonstrated bilateral ptosis, dilatation of bilateral pupils being sluggishly reactive to light, paralysis of extraocular movement, paralysis of soft palate movement, and bilateral hearing disturbances. Except for the involvement of cranial …

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