Central Nervous System Involvement by Small Lymphocytic Lymphoma after a Myxoma-Related Embolic Event

Involvement of the central nervous system by chronic lymphocytic leukemia/small lymphocytic lymphoma is exceedingly rare, and currently no risk factors have been described. We report the case of a patient with concomitant chronic lymphocytic leukemia/small lymphocytic lymphoma and an embolic cerebro...

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Main Authors: Nicolas Gallastegui, Daniel P. Cassidy, Deborah O. Heros, Francisco Vega, Jonathan H. Schatz
Format: Article
Language:English
Published: Wiley 2019-01-01
Series:Case Reports in Hematology
Online Access:http://dx.doi.org/10.1155/2019/1825491
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author Nicolas Gallastegui
Daniel P. Cassidy
Deborah O. Heros
Francisco Vega
Jonathan H. Schatz
author_facet Nicolas Gallastegui
Daniel P. Cassidy
Deborah O. Heros
Francisco Vega
Jonathan H. Schatz
author_sort Nicolas Gallastegui
collection DOAJ
description Involvement of the central nervous system by chronic lymphocytic leukemia/small lymphocytic lymphoma is exceedingly rare, and currently no risk factors have been described. We report the case of a patient with concomitant chronic lymphocytic leukemia/small lymphocytic lymphoma and an embolic cerebrovascular accident related to a cardiac myxoma, who developed parenchymal central nervous system involvement of lymphoma on the ischemic bed. The patient was successfully treated with a high-dose fludarabine-based chemotherapy regimen, achieving a sustained remission. We propose that embolic breakage of the blood-brain barrier may be a major risk factor in producing central nervous system involvement. We also propose that a high-dose fludarabine-based chemotherapy regimen may be adequate to achieve a better CNS penetration and improved outcomes.
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spelling doaj-art-450048b384344b2d91f3aa6c7fc36b5d2025-08-20T02:37:47ZengWileyCase Reports in Hematology2090-65602090-65792019-01-01201910.1155/2019/18254911825491Central Nervous System Involvement by Small Lymphocytic Lymphoma after a Myxoma-Related Embolic EventNicolas Gallastegui0Daniel P. Cassidy1Deborah O. Heros2Francisco Vega3Jonathan H. Schatz4Division of Hematology, Department of Medicine, University of Miami Leonard M. Miller School of Medicine/Sylvester Comprehensive Cancer Center, Miami, FL, USADivision of Hematopathology, Department of Pathology and Laboratory Medicine, University of Miami Leonard M. Miller School of Medicine/Sylvester Comprehensive Cancer Center, Miami, FL, USADivision of Neuro-Oncology, Department of Neurology, University of Miami Leonard M. Miller School of Medicine/Sylvester Comprehensive Cancer Center, Miami, FL, USADivision of Hematopathology, Department of Pathology and Laboratory Medicine, University of Miami Leonard M. Miller School of Medicine/Sylvester Comprehensive Cancer Center, Miami, FL, USADivision of Hematology, Department of Medicine, University of Miami Leonard M. Miller School of Medicine/Sylvester Comprehensive Cancer Center, Miami, FL, USAInvolvement of the central nervous system by chronic lymphocytic leukemia/small lymphocytic lymphoma is exceedingly rare, and currently no risk factors have been described. We report the case of a patient with concomitant chronic lymphocytic leukemia/small lymphocytic lymphoma and an embolic cerebrovascular accident related to a cardiac myxoma, who developed parenchymal central nervous system involvement of lymphoma on the ischemic bed. The patient was successfully treated with a high-dose fludarabine-based chemotherapy regimen, achieving a sustained remission. We propose that embolic breakage of the blood-brain barrier may be a major risk factor in producing central nervous system involvement. We also propose that a high-dose fludarabine-based chemotherapy regimen may be adequate to achieve a better CNS penetration and improved outcomes.http://dx.doi.org/10.1155/2019/1825491
spellingShingle Nicolas Gallastegui
Daniel P. Cassidy
Deborah O. Heros
Francisco Vega
Jonathan H. Schatz
Central Nervous System Involvement by Small Lymphocytic Lymphoma after a Myxoma-Related Embolic Event
Case Reports in Hematology
title Central Nervous System Involvement by Small Lymphocytic Lymphoma after a Myxoma-Related Embolic Event
title_full Central Nervous System Involvement by Small Lymphocytic Lymphoma after a Myxoma-Related Embolic Event
title_fullStr Central Nervous System Involvement by Small Lymphocytic Lymphoma after a Myxoma-Related Embolic Event
title_full_unstemmed Central Nervous System Involvement by Small Lymphocytic Lymphoma after a Myxoma-Related Embolic Event
title_short Central Nervous System Involvement by Small Lymphocytic Lymphoma after a Myxoma-Related Embolic Event
title_sort central nervous system involvement by small lymphocytic lymphoma after a myxoma related embolic event
url http://dx.doi.org/10.1155/2019/1825491
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