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Primary Central Nervous System Lymphoma of the Cerebellopontine Angle That Initially Occurred as Neurolymphomatosis of the Acoustic Nerve

We report a rare case of a primary central nervous system lymphoma (PCNSL) of the cerebellopontine angle (CPA) with infiltration into the pyramidal tract that initially presented as neurolymphomatosis (NL) of the acoustic nerve. A 60-year-old male suffered from right-side deafness and was referred t...

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Autores principales: Tabuchi, Sadaharu, Yoshioka, Hiroki, Nakayasu, Hiroyuki, Watanabe, Takashi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Japan Neurosurgical Society 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5364941/
https://www.ncbi.nlm.nih.gov/pubmed/28663949
http://dx.doi.org/10.2176/nmccrj.2013-0353
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author Tabuchi, Sadaharu
Yoshioka, Hiroki
Nakayasu, Hiroyuki
Watanabe, Takashi
author_facet Tabuchi, Sadaharu
Yoshioka, Hiroki
Nakayasu, Hiroyuki
Watanabe, Takashi
author_sort Tabuchi, Sadaharu
collection PubMed
description We report a rare case of a primary central nervous system lymphoma (PCNSL) of the cerebellopontine angle (CPA) with infiltration into the pyramidal tract that initially presented as neurolymphomatosis (NL) of the acoustic nerve. A 60-year-old male suffered from right-side deafness and was referred to an otolaryngologist. Magnetic resonance imaging (MRI) showed fusiform enlargement of the right acoustic nerve with a hyperintense signal on a T(2)-weighted image (T(2)WI) and with gadolinium (Gd) enhancement, without an evidence of parenchymal CNS involvement. Although he was treated with steroids, his symptoms deteriorated. MRI was performed again and showed the mass lesion at the right CPA with enhancement. In addition to this, a lesion with slightly high intensity on a T(2)WI with Gd enhancement was observed along the right pyramidal tract. Despite steroid pulse therapy, the lesion rapidly progressed. We performed a tumor biopsy, and the histological diagnosis was diffuse large B-cell lymphoma. Pelvic, abdominal, and chest computed tomography scans, gallium cintigraphy, and bone marrow biopsy failed to detect any other evidence of lymphomatous involvement of other organs. We attempted high-dose methotrexate therapy (3.5 g/m(2)). We found a discrepancy in the therapeutic effect between the CPA lesion and the infiltrated lesion along the pyramidal tract; the lesions were chemo-resistant and chemo-sensitive, respectively. After completion of the second courses of chemotherapy, we began radiotherapy (total dose: 36 Gy). Four months after radiotherapy, the CPA tumor completely disappeared. Thirty-three months after the biopsy, he is doing well with a normal daily life and no signs of recurrence.
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spelling pubmed-53649412017-06-29 Primary Central Nervous System Lymphoma of the Cerebellopontine Angle That Initially Occurred as Neurolymphomatosis of the Acoustic Nerve Tabuchi, Sadaharu Yoshioka, Hiroki Nakayasu, Hiroyuki Watanabe, Takashi NMC Case Rep J Case Report We report a rare case of a primary central nervous system lymphoma (PCNSL) of the cerebellopontine angle (CPA) with infiltration into the pyramidal tract that initially presented as neurolymphomatosis (NL) of the acoustic nerve. A 60-year-old male suffered from right-side deafness and was referred to an otolaryngologist. Magnetic resonance imaging (MRI) showed fusiform enlargement of the right acoustic nerve with a hyperintense signal on a T(2)-weighted image (T(2)WI) and with gadolinium (Gd) enhancement, without an evidence of parenchymal CNS involvement. Although he was treated with steroids, his symptoms deteriorated. MRI was performed again and showed the mass lesion at the right CPA with enhancement. In addition to this, a lesion with slightly high intensity on a T(2)WI with Gd enhancement was observed along the right pyramidal tract. Despite steroid pulse therapy, the lesion rapidly progressed. We performed a tumor biopsy, and the histological diagnosis was diffuse large B-cell lymphoma. Pelvic, abdominal, and chest computed tomography scans, gallium cintigraphy, and bone marrow biopsy failed to detect any other evidence of lymphomatous involvement of other organs. We attempted high-dose methotrexate therapy (3.5 g/m(2)). We found a discrepancy in the therapeutic effect between the CPA lesion and the infiltrated lesion along the pyramidal tract; the lesions were chemo-resistant and chemo-sensitive, respectively. After completion of the second courses of chemotherapy, we began radiotherapy (total dose: 36 Gy). Four months after radiotherapy, the CPA tumor completely disappeared. Thirty-three months after the biopsy, he is doing well with a normal daily life and no signs of recurrence. The Japan Neurosurgical Society 2014-06-19 /pmc/articles/PMC5364941/ /pubmed/28663949 http://dx.doi.org/10.2176/nmccrj.2013-0353 Text en © 2014 The Japan Neurosurgical Society This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-nd/4.0/
spellingShingle Case Report
Tabuchi, Sadaharu
Yoshioka, Hiroki
Nakayasu, Hiroyuki
Watanabe, Takashi
Primary Central Nervous System Lymphoma of the Cerebellopontine Angle That Initially Occurred as Neurolymphomatosis of the Acoustic Nerve
title Primary Central Nervous System Lymphoma of the Cerebellopontine Angle That Initially Occurred as Neurolymphomatosis of the Acoustic Nerve
title_full Primary Central Nervous System Lymphoma of the Cerebellopontine Angle That Initially Occurred as Neurolymphomatosis of the Acoustic Nerve
title_fullStr Primary Central Nervous System Lymphoma of the Cerebellopontine Angle That Initially Occurred as Neurolymphomatosis of the Acoustic Nerve
title_full_unstemmed Primary Central Nervous System Lymphoma of the Cerebellopontine Angle That Initially Occurred as Neurolymphomatosis of the Acoustic Nerve
title_short Primary Central Nervous System Lymphoma of the Cerebellopontine Angle That Initially Occurred as Neurolymphomatosis of the Acoustic Nerve
title_sort primary central nervous system lymphoma of the cerebellopontine angle that initially occurred as neurolymphomatosis of the acoustic nerve
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5364941/
https://www.ncbi.nlm.nih.gov/pubmed/28663949
http://dx.doi.org/10.2176/nmccrj.2013-0353
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