CNS lymphomatoid granulomatosis with lymph node and bone marrow involvements

Neuropathology. 2008 Dec;28(6):640-4. doi: 10.1111/j.1440-1789.2008.00903.x. Epub 2008 Apr 1.

Abstract

Lymphomatoid granulomatosis (LYG) in the CNS is an uncommon lymphoproliferative disease with characteristic angiocentric lymphoreticular proliferative and granulomatous lesions exhibiting low-grade malignant potential. Here we report a rare case of CNS-LYG, which disseminated to the lymph node and bone marrow. A 50-year-old man was diagnosed with CNS-LYG based on brain biopsy showing perivascular infiltration of CD3-positive small T-lymphocytes without overt nuclear atypism. Eight months after the initial neurological symptoms, inguinal lymph node swelling was found and histopathologically diagnosed as peripheral T-cell lymphoma. TCRgamma-gene rearrangement study using both paraffin-embedded specimens of brain and inguinal lymph node demonstrated an identical clonal band. Considering the clinical course, we concluded lymph node involvement of CNS-LYG, suggesting the malignant potential of CNS-LYG.

Publication types

  • Case Reports

MeSH terms

  • Bone Marrow / pathology*
  • Brain Neoplasms / genetics
  • Brain Neoplasms / pathology*
  • Cell Nucleus Shape
  • Gene Rearrangement, T-Lymphocyte
  • Genes, T-Cell Receptor gamma
  • Humans
  • Lymph Nodes / pathology*
  • Lymphoma, T-Cell, Peripheral / pathology
  • Lymphomatoid Granulomatosis / pathology*
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Polymerase Chain Reaction
  • Polymorphism, Single-Stranded Conformational
  • T-Lymphocytes / immunology
  • T-Lymphocytes / pathology