Lymphoma of Nervous System or the Great Imitator in Neurology

Background: Lymphoma of the central nervous system (CNS), both primary and secondary, represents a very rare part patients with non-Hodgkin lymphoma. Methods: Exams included neurological exam, laboratory blood tests, МRI, biopsy, electromyography. Results: Three different clinical cases lymphoma are presented. The first patient is 44-year-old male admitted to emergency room because neck stiffness, MRI data for tumour in left cavernous sinus area. Biopsy was performed 3 months prior hospitalisation, showing connective tissue, partially hyalinised. Lumbar tap exclude CNS infection. Cerebrospinal fluid (CSF) examination showed lymphocytic pleocytosis, atypical cells phases mitosis, result did not confirm choriomeningitis. Flow cytometric measurement (FCM) CSF led diagnosis T-lymphoblastic CNS. second 50-year-old female hospitalised authors’ department lower limb weakness decreased sensation, dysphagia, facial nerve palsy. Brain no abnormal lesions. Guillain–Barré syndrome considered after performing electromyography electroneurography. pleocytosis 47% them were atypical. FCM helped authors diagnose B-lymphoblastic third case presents 63-year-old right sided hemiparesis progressive cognitive impairment. Previously CTs MRIs brain hemispheres cerebellar peduncle diffuse Ischaemic stroke, tumour, infectious disease considered. Most these excluded pathological findings. tissue biopsy one lesions performed, diagnosed large B cell Conclusion: disease. Differential diagnoses include conditions. could be useful complicated unknown affecting