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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 (right cerebral peduncle, caudate nucleus)

Personal Characteristics

69 -year-old female

Clinical Characteristics

She had a 2 week history of altered mental status, left hemiparesis, and bell palsy initial CT without ontrast demonstrated hyperdense lesions involving the right cerebral peduncle with extension across the internal capsule to involve the caudate nucleus mass effect was present although edema was absent serial cts were performed the transient nature of the lesions suggested a self-limiting process such as infarction or hemorrhage the hemiparesis initially regressed minimally, but then slow progressive deteriation in the neurologic and general body functions developed 3 months later after the initial CT, she died apparently of non-neurologic causes autopsy identified malignant undifferentiated lymphoma, affecting the brain diffusely foci of severe involvement were seen in the regions that initially showed abnormalities on CT, infarcted tissue was visualized within and adjacent to these lesions

Remission Characteristics

Serial cts over the next two weeks with and without contrast demonstrated a gradual regression in lesion density and mass effect minimal contrast enhancement was identified on the second study but subsequently resolved

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

None reported

Non-Clinical Treatment

None reported