Abstract
Primary central nervous system lymphoma (PCNSL) is rare. Clinical and histological differential diagnosis of systemic lymphoma and sarcoidosis continues to be a challenge. The first case report in the German and English literature of PCNSL and synchronous sarcoidosis is presented. Synchronous mediastinal lymphadenopathy suggestive of non-Hodgkin’s lymphoma (NHL) or sarcoidosis was noted. Both conditions require alternative therapeutic and prognostic considerations to PCNSL. A regime of intrathecal and adjuvant systemic chemotherapy led to transient clinical improvement prior to the patient’s demise through overwhelming sepsis and multiorgan failure. Post mortem findings confirmed synchronous PCNSL with mediastinal lymph node sarcoidosis.
References
Olson JE, Janney CA, Rao RD, Cerhan JR, Kurtin PJ, Schiff D, Kaplan RS, O’Neill BP (2002) The continuing increase in the incidence of primary central nervous system non-Hodgkin lymphoma: a surveillance, epidemiology, and end results analysis. Cancer 95:1504–1510
Batchelor T, Loeffler JS (2006) Primary CNS lymphoma. J Clin Oncol 24:1281–1288
Young RC, Howser DM, Anderson T, Fisher RI, Jaffe E, DeVita VT Jr (1979) Central nervous system complications of non-Hodgkin’s lymphoma. The potential role for prophylactic therapy. Am J Med 66:435–443
Abrey LE, Yahalom J, DeAngelis LM (2000) Treatment for primary CNS lymphoma: the next step. J Clin Oncol 18:3144–3150
Motta M, Alongi F, Bolognesi A, Cozzarini C, Di Muzio N, Fazio F (2008) Remission of refractory neurosarcoidosis treated with brain radiotherapy: a case report and a literature review. Neurologist 14:120–124
Nunes H, Bouvry D, Soler P, Valeyre D (2007) Sarcoidosis. Orphanet J Rare Dis 2:46
Diener H, Putzki N (2008) Leitlinien für Diagnostik und Therapie in der Neurologie. Thieme, Stuttgart
Patel AV, Stickler DE, Tyor WR (2007) Neurosarcoidosis. Curr Treat Options Neurol 9:161–168
Hoitsma E, Faber CG, Drent M, Sharma OP (2004) Neurosarcoidosis: a clinical dilemma. Lancet Neurol 3:397–407
Haldorsen IS, Krakenes J, Krossnes BK, Mella O, Espeland A (2009) CT and MR imaging features of primary central nervous system lymphoma in Norway, 1989–2003. Am J Neuroradiol 30:744–751
Ji J, Shu X, Li X, Sundquist K, Sundquist J, Hemminki K (2009) Cancer risk in hospitalized sarcoidosis patients: a follow-up study in Sweden. Ann Oncol 20:1121–1126
García Casares E, Soria L, Melchor E, Blasco S, Calmet F, Oliver G, Pérez S (2009) Sarcoidosis-lymphoma syndrome. Reumatol Clin 5:31–33
Brincker H, Wilbek E (1974) The incidence of malignant tumours in patients with respiratory sarcoidosis. Br J Cancer 29:247–251
Brincker H (1986) The sarcoidosis-lymphoma syndrome. Br J Cancer 54:467–473
Reich JM (1985) Acute myeloblastic leukemia and sarcoidosis. Implications for pathogenesis. Cancer 55:366–369
Braylan RC, Long JC, Jaffe ES, Greco FA, Orr SL, Berard CW (1977) Malignant lymphoma obscured by concomitant extensive epithelioid granulomas: report of three cases with similar clinicopathologic features. Cancer 39:1146–1155
Dunphy CH, Panella MJ, Grosso LE (2000) Low-grade B-cell lymphoma and concomitant extensive sarcoidlike granulomas: a case report and review of the literature. Arch Pathol Lab Med 124:152–156
Brunner A, Kantner J, Tzankov A (2005) Granulomatous reactions cause symptoms or clinically imitate treatment resistance in small lymphocytic lymphoma/chronic lymphocytic leukaemia more frequently than in other non-Hodgkin lymphomas. J Clin Pathol 58:815–819
Linnenberg HS, Medici TC, Rhyner K (1992) The “sarcoidosis-lymphoma syndrome”—a lymphocyte dysregulation? Pneumologie 46:229–235
Acknowledgements
We thank Dr Hischam Taha, Derriford Hospital, Plymouth, UK, for carefully reviewing the manuscript.
Author information
Authors and Affiliations
Corresponding author
Additional information
E.J. Greiner and L.-O. Mügge share first authorship.
Rights and permissions
About this article
Cite this article
Greiner, E.J., Mügge, LO., Romeike, B.F.M. et al. A case with coincidental diagnosis of primary central nervous system lymphoma and lymph node sarcoidosis. J Neurooncol 99, 129–134 (2010). https://doi.org/10.1007/s11060-009-0101-4
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11060-009-0101-4