Lymphomatosis cerebri showing transient spontaneous regression

• Published in: Neurology and clinical neuroscience Vol. 5; no. 3; pp. 93 - 95
• Main Authors: Inamasu, Joji, Nishimoto, Masaaki, Kitamura, Yohei, Mayanagi, Keita, Nakatsukasa, Masashi, Yoshii, Masami, Oshima, Takeo, Tomiyasu, Kazuhiro
• Format: Journal Article
• Language: English
• Published: Tokyo Wiley Subscription Services, Inc 01-05-2017
• Subjects: Atrophy; B-cell lymphoma; Biopsy; Central nervous system; Cerebral hemispheres; Cognitive ability; leukoencephalopathy; Lymphocytes B; Lymphoma; lymphomatosis cerebri; Magnetic resonance imaging; Metastases; multiple sclerosis; Neuroimaging; NMR; Nuclear magnetic resonance; spontaneous regression; Substantia alba
• ISSN: 2049-4173; 2049-4173
• DOI: 10.1111/ncn3.12120

We describe the case of a 35‐year‐old man who presented with a seizure. Brain magnetic resonance imaging showed multiple white matter lesions in the cerebral hemispheres. His seizure was controllable with antiepileptics, and he remained asymptomatic for the next 4 months with follow‐up magnetic resonance imaging showing transient spontaneous regression. However, he developed progressive decline in cognitive functions approximately 1 year after symptom onset. Magnetic resonance imaging showed recurrence of the white matter lesions and progression of brain atrophy. A brain biopsy established the pathological diagnosis of diffuse large B‐cell lymphoma, and he was clinically diagnosed with lymphomatosis cerebri. Lymphomatosis cerebri is a rare variant of primary central nervous system lymphoma characterized by diffuse infiltration of lymphomatous cells into the brain without forming a cohesive tumor mass. Although the clinical and radiographic course is rapidly progressive in the great majority of patients with lymphomatosis cerebri, transient spontaneous regression can occur, posing diagnostic challenges for physicians.