We present the case of a 56-year old man who developed -at the age of 46-paraesthesia and numbness in the perianal region, the feet and lower legs accompanied by the presence of B-lymphocytes in the cerebrospinal fluid (CSF). Despite intensive work-up an explanation was not found until he developed hepato-splenomegaly ten years after the initial symptoms. Haematologic evaluation at that time disclosed a low-grade malignant B-cell lymphoma. Repeated CSF examination revealed 31 leukocytes/mm3, of which were mainly lymphocytes. These proved to be B-lymphocytes of monoclonal origin.
These findings suggest that a leptomeningeal localisation of a low-grade malignant lymphoma had been present for ten years before systemic manifestation of the disease.
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Heimans, J.J., Wijermans, P.W., Polman, C.H. et al. Longterm meningeal involvement as the only clinical manifestation of low grade malignant non-Hodgkin's lymphoma. J Neuro-Oncol 9, 275–277 (1990). https://doi.org/10.1007/BF02341158
- low-grade non-Hodgkin's lymphoma
- leptomeningeal involvement