A case of primary intraocular central nervous system lymphoma with high interleukin 10 level and positive cytology in cerebrospinal fluid

• Hideyama Takuto

  Department of Neurology, International Medical Center of Japan

• Tanaka Hiroshi

  Department of Neurology, International Medical Center of Japan

• Uesaka Yoshikazu

  Department of Neurology, International Medical Center of Japan

• Kunimoto Masanari

  Department of Neurology, International Medical Center of Japan

• Miwa Akiyoshi

  Department of Hematology, International Medical Center of Japan

Bibliographic Information

Other Title

• 髄液中ＩＬ‐１０高値から髄液細胞診をくりかえし陽性所見をえた眼内中枢神経原発Ｂ細胞悪性リンパ腫の１例
• 髄液中IL-10高値から髄液細胞診をくりかえし陽性所見をえた眼内中枢神経原発B細胞悪性リンパ腫の1例
• ズイエキチュウ IL 10 コウチ カラ ズイエキ サイボウシン オ クリカエシ ヨウセイ ショケン オ エタ ガンナイ チュウスウ シンケイ ゲンパツ Bサイボウ アクセイ リンパシュ ノ 1レイ

Abstract

A 73-year-old woman was admitted to the surgical department of our hospital for endoscopic resection of a colonic polyp. The day after endoscopic resection, she became drowsy and dysphasic. Two days later, left hemiparesis and gait difficulty developed. The next day, hemiparesis progressed bilaterally and dyspnea developed due to upper airway stenosis. The most prominent signs were those of bulbar palsy. Blood analysis revealed mild inflammatory responses and hyponatremia. T2-weighted magnetic resonance imaging showed high-intensity lesions in the swollen medulla and cervical spinal cord. Those areas and the meninges of the posterior fossa were enhanced by gadolinium. Steroid pulse therapy was administered, resulting in rapid recovery of bulbar and paretic symptoms with decreased enhanced area. At this point, concentration of cerebrospinal fluid interleukin (IL)-10 was markedly elevated at 146pg/ml (normal, <5pg/ml), suggesting malignant lymphoma. Cytology of the cerebrospinal fluid was repeatedly examined, eventually revealing atypical lymphocytes with hyperlobulated nuclei and clear nucleoli. Lymphocytes stained with anti-CD20 antibody. These findings strongly suggested a diagnosis of primary intraocular and central nervous system lymphoma. In the present case, repeated cytology of cerebrospinal fluid was highly important for diagnosis in this case of high IL-10 level in cerebrospinal fluid.<br>

Journal

• Rinsho Shinkeigaku

  Rinsho Shinkeigaku 48 (6), 415-418, 2008

  Societas Neurologica Japonica

Keywords

• IL-10
• cytology of cerebrospinal fluid
• diffuse large B cell lymphoma
• MRI

Details

• CRID: 1390001205034463744
• NII Article ID: 130004504513
• NII Article ID: 10021187774
• NII Book ID: AN00253207
• DOI: 10.5692/clinicalneurol.48.415
• ISSN: 18820654
• ISSN: 0009918X
• ISSN: http://id.crossref.org/issn/0009918X
• NDL BIB ID: 9553163
• Web Site: https://ndlsearch.ndl.go.jp/books/R000000004-I9553163
• Web Site: https://search.jamas.or.jp/link/ui/2008257457
• Text Lang: ja
• Data Source:
  • JaLC
  • NDL
  • Crossref
  • CiNii Articles
• Abstract License Flag: Disallowed