Rinsho Shinkeigaku (Clinical Neurology)

Case Report

A case of secondary central nervous system lymphoma presenting marked hypoglycorrhachia

Aya Yamashita, M.D.1), Masahiro Tokuda, M.D.1), Masatoshi Matsuo, M.D., Ph.D.2), Junji Irie, M.D., Ph.D.3), Yohei Tateishi, M.D., Ph.D.4) and Kazuo Mutsukura, M.D., Ph.D.1)

1)Department of Neurology, Nagasaki Harbor Medical Center
2)Department of Hematology, Nagasaki Harbor Medical Center
3)Department of Pathology, Nagasaki Harbor Medical Center
4)Department of Neurology and Strokology, Nagasaki University Hospital

A 67-year-old male was transferred to our hospital with diplopia, decreased deep tendon reflex and ataxia. He had been suspected Fisher syndrome because of previous upper respiratory tract infection. A cerebrospinal fluid examination showed marked hypoglycorrhachia, pleocytosis and elevated protein, and cytological examination suggested malignant lymphoma. Abdominal computed tomography revealed a left adrenal mass. A biopsy of the left adrenal mass revealed diffuse large B-cell lymphoma. He was treated with a combination of R-CHOP (rituximab, cyclophosphamide, doxorubicin hydrochloride, oncovin and prednisolone) and intrathecal administration of methotrexate, cytarabine and prednisolone. Neurological symptoms were gradually improved. Malignancy should be considered in addition to bacterial, fungal or tuberculous meningitis in a case with marked hypoglycorrhachia.
Full Text of this Article in Japanese PDF (2513K)

(CLINICA NEUROL, 59: 365|370, 2019)
key words: hypoglycorrhachia, secondary central nervous system lymphoma, diffuse large B-cell lymphoma, oculomotor nerve palsy

(Received: 10-Feb-19)