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Next Article 
Central nervous system complications in patients with diffuse histiocytic
and undifferentiated lymphoma: leukemia revisited
PA Bunn , PS Schein, PM Banks and VT DeVita
Fifteen of 52 patients (29%) with diffuse histiocytic and undifferentiated
pleomorphic lymphoma developed central nervous system (CNS) complications,
primarily leptomeningeal lymphoma. Lumbar puncture with cerebrospinal fluid
cytology was the most useful test for diagnosis, and for following the
response to therapy. Leptomeningitis developed during all stages of the
patients' clinical course: at time of diagnosis, during progression of
systemic disease, and most importantly as the initial site of relapse
within 7 mo of attaining a complete clinical remission. Patients with bone
marrow involvement are at high risk for the development of leptomeningeal
lymphoma. Pathologic findings suggest that entry into the leptomeninges
involves extension from the medullary bone marrow cavity along perforating
vessels through dura into the arachnoid space. The leptomeningeal lymphoma
has been successfully controlled in all patients receiving intensive
central nervous system therapy consisting of a combination of intrathecal
drug administration and radiotherapy. The high frequency of this syndrome
and the success in its control suggest that a controlled trial of
prophylactic CNS therapy be instituted in patients with these histologic
types of non-Hodgkin's lymphomas.
Volume 47,
Issue 1,
pp. 3-10,
01/01/1976
Copyright © 1976 by The American Society of Hematology
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