T-cell Lymphoma Presenting Neutrophilic Inflammation in the Cerebrospinal Fluid

Intern Med. 2020 Feb 15;59(4):573-576. doi: 10.2169/internalmedicine.3093-19. Epub 2019 Oct 7.

Abstract

A 66-year-old woman presented with upper abdominal pain and weakness in the limbs. She had bilateral uveitis and gastric ulcers. A neurological examination revealed tetraparesis and sensory disturbance in the right arm. A cerebrospinal fluid (CSF) examination showed polymorphonuclear pleocytosis with elevated pro-inflammatory cytokine levels. Magnetic resonance imaging showed brain lesions and a long spinal cord lesion. She was initially diagnosed with neuro-Behçet's disease and was treated with corticosteroids, resulting in no improvement. A gastric mucosa biopsy indicated T-cell lymphoma colocalizing with neutrophils. The cytokine-mediated neutrophilic inflammation probably caused characteristic CSF and histopathological features. It is noteworthy that T-cell lymphoma may present with CSF neutrophilic inflammation.

Keywords: interleukin-17; interleukin-6; interleukin-8; neuro-Behçet's disease; neuro-neutrophilic disease; polymorphonuclear leukocyte.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Antineoplastic Agents / adverse effects*
  • Antineoplastic Agents / therapeutic use*
  • Fatal Outcome
  • Female
  • Humans
  • Inflammation / chemically induced*
  • Lymphoma, T-Cell / complications*
  • Lymphoma, T-Cell / drug therapy*
  • Lymphoma, T-Cell / mortality*
  • Lymphoma, T-Cell / physiopathology
  • Magnetic Resonance Imaging
  • Male
  • Neutrophils / drug effects*
  • Spinal Cord Diseases / chemically induced*

Substances

  • Antineoplastic Agents