Abstract
We report the case of a 30-year-old HIV-infected man admitted for a meningeal syndrome and a zoster rash. The CSF had cytological features suggesting a primary CNS lymphoma (PCNSL). The large lymphoid cells had a fine chromatin with nucleoli, a basophilic cytoplasm with azurophilic granules and high mitotic activity. Several arguments demonstrated the viral origin of the meningitis: the large lymphoid cells were of T origin with no evidence of clonal TCR gamma gene rearrangement. The PCR was positive for Varicella-Zoster Virus (VZV) and EBV DNA. Clinical evolution was favorable under acyclovir. We should be cautious in the differential diagnosis between viral meningitis and PCNSL.
MeSH terms
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Adult
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Central Nervous System Neoplasms / cerebrospinal fluid
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Central Nervous System Neoplasms / diagnosis
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Central Nervous System Neoplasms / virology*
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DNA, Viral / cerebrospinal fluid
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Diagnosis, Differential
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Epstein-Barr Virus Infections / cerebrospinal fluid
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Epstein-Barr Virus Infections / virology
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Ganciclovir / therapeutic use
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Herpes Zoster / cerebrospinal fluid
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Herpes Zoster / diagnosis*
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Herpes Zoster / physiopathology
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Herpesvirus 3, Human / isolation & purification
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Herpesvirus 3, Human / pathogenicity*
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Herpesvirus 4, Human / isolation & purification
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Humans
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Lymphoma, AIDS-Related / cerebrospinal fluid
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Lymphoma, AIDS-Related / diagnosis
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Lymphoma, AIDS-Related / virology*
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Male
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Meningitis, Viral / diagnosis*
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Polymerase Chain Reaction