Synchronous Primary Central Nervous System and Pulmonary Lymphoma in a 7-Year-Old Female with Unspecified T-Cell Immunodeficiency

Pediatr Neurosurg. 2018;53(5):311-316. doi: 10.1159/000490728. Epub 2018 Aug 15.

Abstract

Primary central nervous system lymphoma (PCNSL) is rare in children with immunocompromise as an important risk factor. A 7-year-old girl with unspecified T-cell immunodeficiency presented with left-sided weakness and was found to have a right-sided frontal lobe mass on imaging. The mass was resected; histopathology and molecular studies evidenced diffuse large B-cell lymphoma. Prior chest imaging had revealed left upper lobe mass, and repeat chest imaging revealed multiple pulmonary nodules, initially concerning for metastasis. Video-assisted thoracoscopic surgical wedge resection of the lung mass was performed; the molecular profile was distinct from the PCNSL, suggesting synchronous de novo lymphomagenesis of brain and pulmonary primaries.

Keywords: Immunodeficiency; Primary central nervous system lymphoma; Pulmonary lymphoma.

Publication types

  • Case Reports

MeSH terms

  • Central Nervous System Neoplasms / diagnostic imaging
  • Central Nervous System Neoplasms / pathology*
  • Central Nervous System Neoplasms / surgery*
  • Child
  • Diagnosis, Differential
  • Female
  • Frontal Lobe
  • Humans
  • Lung Neoplasms / diagnostic imaging
  • Lung Neoplasms / pathology*
  • Lung Neoplasms / surgery*
  • Lymphoma, Large B-Cell, Diffuse / diagnostic imaging
  • Lymphoma, Large B-Cell, Diffuse / pathology*
  • Lymphoma, Large B-Cell, Diffuse / surgery
  • Magnetic Resonance Imaging
  • Neoplasms, Multiple Primary / diagnostic imaging
  • Neoplasms, Multiple Primary / pathology*
  • Neoplasms, Multiple Primary / surgery*
  • Thoracic Surgery, Video-Assisted / methods