Primary central nervous system lymphoma presenting with multiple myeloma-like clinical picture

Primary cerebral lymphoma is a unique and infrequent CNS malignancy in which the B lymphocyte subtype constitutes most cases. 1 B cell neoplasms other than multiple myeloma including non-Hodgkin's lymphomas, and acute and chronic leukaemias might also exhibit lytic bone lesions, hypercalcaemia,...

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Bibliographic Details
Published in:Journal of neurology, neurosurgery and psychiatry neurosurgery and psychiatry, 1997-09, Vol.63 (3), p.409-410
Main Authors: ÇELIK, ISMAIL, BASÇIL, NESLIHAN, BARISTA, IBRAHIM, GÜLLÜ, IBRAHIM, TEKUZMAN, GÜLTEN, FIRAT, DINÇER
Format: Article
Language:English
Subjects:
Blood-brain barrier
Brain - pathology
Diagnosis, Differential
Female
Humans
Letters to the Editor
Lymphoma
Lymphoma - pathology
Magnetic Resonance Imaging
Middle Aged
Multiple myeloma
Multiple Myeloma - pathology
Tumors
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Summary:Primary cerebral lymphoma is a unique and infrequent CNS malignancy in which the B lymphocyte subtype constitutes most cases. 1 B cell neoplasms other than multiple myeloma including non-Hodgkin's lymphomas, and acute and chronic leukaemias might also exhibit lytic bone lesions, hypercalcaemia, and monoclonal gammopathy via the particular actions of interleukin (IL-1), IL-6, or tumour necrosis factor-[alpha] secreted by the neoplastic B cell clone, but not reported previously secondary to a primary cerebral lymphoma. 2 We describe an unusual presentation of a B cell primary cerebral lymphoma mimicking a plasma cell dyscrasia. Despite the differences in localisation and biology, non-Hodgkin's lymphomas arising from the CNS are not histologically different from the ones arising at extraneural sites, except that almost all have intermediate or high grade histology, predominantly of B cell subtype. 4 The monoclonality of intracellular immunoglobulins and cell lines obtained from primary cerebral lymphoma tissue cultures is well established. 5 These specific clonal products might be detected in CSF but not reflected in systemic circulation probably owing to the presence of an intact blood-brain barrier that, to the our knowledge, a B cell primary cerebral lymphoma with raised serum monoclonal paraprotein and lytic skull lesions simulating multiple myeloma has not been previously reported.
ISSN:0022-3050
1468-330X
DOI:10.1136/jnnp.63.3.409