Case Report: A Woman with Fever, Acute Changes in Mental State, and Progressive Neurological Degeneration

Vol 4 | Issue 3 | Sep-Dec 2018 | page: 17-20 |Carrillo-Torres Orlando, Rivero-Sigarroa Eduardo, Loeza-Guemez Alejandro.


Authors: Carrillo-Torres Orlando [1], Rivero-Sigarroa Eduardo [1], Loeza-Guemez Alejandro[1].

[1] Department of anesthesiology of the Hospital General de México “Dr. Eduardo Liceaga”.

Address of Correspondence

Dr. Orlando Carrillo Torres,

Av. Cuauhtemoc 590, Narvarte Poniente Benito Juarez. CxMx CP 03020 Email:orlo_78@hotmail.com


Abstract

Introduction: Anaplastic large cell lymphoma (ALCL), which was first described by Stein in 1985 as a feature of CD30 positivity, is now acknowledged as a distinct subset of T-cell non-Hodgkin lymphomas (NHL). It accounts for approximately 3% of adult NHL while constitutes as many as 30%–40% of pediatric large-cell lymphomas. It is rarely metastasized to other sites, especially to the central nervous system (CNS).

Case Report: We present a case of a 73-year-old woman hospitalized for fever, acute behavioral changes, and progressive neurological degeneration; a rare case of systemic ALCL which metastasized to the brain. There are very few case reports of this matter in the literature.

Conclusion: In the management of patients with neurological impairment, cognitive, and behavioral changes, we suspect the presence of lymphomas associated with the CNS still suspicious of other primary causes.

Keywords: Anaplastic large-cell lymphoma, anaplastic lymphoma kinase gene, primary central nervous system lymphoma, non-Hodgkin lymphoma, T-cell lymphoma, lymph node enlargement.


References

  1. Jaffe ES. Anaplastic large cell lymphoma: The shifting sands of diagnostic hematopathology. Mod Pathol 2001;14:219-28.
  2. d’Amore F, Relander T, Lauritzsen GF, Jantunen E, Hagberg H, Anderson H, et al. Up-front autologous stem-cell transplantation in peripheral T-cell lymphoma: NLG-T-01. J Clin Oncol 2012;30:3093-9.
  3. Nomura M, Narita Y, Miyakita Y, Ohno M, Fukushima S, Maruyama T, et al. Clinical presentation of anaplastic large-cell lymphomain the central nervous system. Mol Clin Oncol 2013;1:655-60.
  4. Bryan RN, Levy LM, Whitlow WD, Killian JM, Preziosi TJ, Rosario JA. Diagnosis of acute cerebral infarction: Comparison of CT and MR imaging. AJNR Am J Neuroradiol 1991;12:611-20.
  5. Adams HP Jr, Brott TG, Crowell RM, Furlan AJ, Gomez CR, Grotta J, et al. Guidelines for the management of patients with acute ischemic stroke. A statement for healthcare professionals from a special writing group of the Stroke Council, American Heart Association. Stroke 1994;25:1901-14.
  6. Fitch MT, van de Beek D. Emergency diagnosis and treatment of adult meningitis. Lancet Infect Dis 2007;7:191-200.
  7.  Tierney LM Jr, Thabet A, Nishino H. Case records of the Massachusetts
    General Hospital. Case 10-2011. A woman with fever, confusion, liver failure, anemia, and thrombocytopenia. N Engl J Med 2011;364:1259-70.
  8. Angus DC, van der Poll T. Severe sepsis and septic shock. N Engl J Med 2013;369:840-51.
  9. Bernal W, Wendon J. Acute liver failure. N Engl J Med 2013;369:2525-34.
  10. Bagshaw SM, Gibney RT. Conventional markers of kidney function. Crit Care Med 2008;36 4 Suppl:S152-8.
  11. Lister A, Abrey LE, Sandlund JT. Central nervous system lymphoma. Hematology Am Soc Hematol Educ Program 2002:283-96.
  12. Pauls S, Fischer A, Brambs H, Fetscher S, Höche W, Bommer M, et al. Use of magnetic resonance imaging to detect neoplasic meningitis: Limited use in leukemia and lymphoma but convincing result in solid tumors. Eur J Radiol 2012;81:974-8.
  13. Fischer L, Jahnke K, Martus P, Weller M, Thiel E, Korfel A, et al. The diagnostic value of cerebrospinal fluid pleocytosis and protein in the detection of limphomatous meningitis in primary central nervous system lymphomas. Hematologia 2006;91:429-30.

How to Cite this Article: Orlando CT, Eduardo RS, Alejandro LG. Case Report: A Woman with Fever, Acute Changes in Mental State, and Progressive Neurological Degeneration. Journal of Anaesthesia and Critical Care Case Reports Sep-Dec 2018; 4(3):17-20.

(Abstract)      (Full Text HTML)      (Download PDF)


.