Primary Cerebellar Lymphoma in an Immunocompetent Host: A Case Report
Keywords:
Non-Hodgkin’s lymphoma, CerebellumAbstract
Primary central nervous system lymphoma (PCNSL) has been rarely found, viz. it accounts for 2- 4 % of all primary brain tumors. Furthermore,PCNSL of the cerebellum is much more rarely reported than that of the cerebrum, particularly in immunocompetent patients. Herein we presented a case of Non-Hodgkin’s lymphoma (NHL) confining within the cerebellum in an immunocompetent Thai man. He was a 62-year-old Thai patient who complained of gradually progressive headache and ataxia for two months without fever or weight loss. The physical examination found only ataxic gait, positive finger-to-nose test of the right side, no peripheral lymphadenopathy, and no hepatosplenomegaly. The computerized tomography (CT) and the brain's magnetic resonance imaging (MRI) showed a 2.5x3.0 cm. mass in the left cerebellum with obstructive hydrocephalus. The chest and abdomen CT showed only a few sub-centimeter lymph nodes in the chest and abdomen. The HIV antigen/antibody was tested negative. He was treated with the operation; the tumor mass was nearly entirely removed. The microscopic pathology of the mass resected was diffuse large cell lymphoma, but its specific immunophenotype could not be concluded because the study was not performed. Six courses of CHOP chemotherapy without high-dose methotrexate, and rituximab administration were the further treatment. He could tolerate chemotherapy well and survive without residual cerebellar mass. Finally, he was regularly treated with aspirin, simvastatin, and phenytoin and clinically followed for years till the date of this report writing.
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