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Spontaneous Regression Of Intracerebral Lymphoma

Weingarten et al., 1983Lymphoma

WeingARTen, K. L., Zimmerman, R. D., & Leeds, N. E. (1983). spontaneous regression of intracerebral lymphoma. Radiology, 149(3), 721–724. https://doi.org/10.1148/radiology.149.3.6359262

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Abstract

Transient spontaneous regression of lesions was identified in four patients with intracerebral lymphoma. This finding, which may be related to cyclic changes in biological tumor activity as well as infarction and/or hemorrhage within the neoplasm, is not a good prognostic sign. Furthermore, when initial neuroradiologic studies suggest a diagnosis of lymphoma, subsequent spontaneous resolution of lesions should not be mistaken for a reliable sign of a benign, self-limiting disease. The diagnosis of this malignant neoplasm, despite regression of lesions, should be aggressively pursued early in the patient's clinical course when therapy would be most beneficial.

Case Details

Disease Location

Intracerebral (septum pellucidum, cc, right bg)

Personal Characteristics

61 -year-old male he had been treated with radiotherapy for lymphoma of the sphenoid sinus and nasopharynx (erroneously diagnosed as an anaplastic carcinoma) three years previously

Clinical Characteristics

He had a 2 week history of confusion, obtundation, and the syndrome of inappropriate secretion of antidiuretic hormones initial CT scan showed hyperdense enhancing lesions within the septum pellucidum, corpus calosum, and the right basal ganglia adjacent white-matter edema as well as mass effect on the frontal horns of the lateral ventricles were also noted following the sr and clinical and CT findings, there was clinical deterioration and recurrence of the lesions on CT. He was treated with steroids 3 months later, his condition deteriorated again and CT revealed recurrent lesions which had increased in size and were more widespread he died shortly after, 5 months after the initial CT exam autopsy revealed recurrent malignant histiocytic lymphoma involving the nasopharynx

Remission Characteristics

Over the next months, without specific therapy, the patient improved clinically and serial cts demonstrated a decrease in the size, density, and enhancement of the lesions and resolution of mass effect lesions involuted again after steroids

Treatment & Mechanisms

Proposed Remission Mechanisms

No major mechanism proposed mention of vessel invasion that may lead to occlusion with secondary infarction and/or hemorrhage into tumor tissue

Clinical Treatment

Steroids

Non-Clinical Treatment

None reported