Original article Central nervous system involvement in indolent lymphomas

aggressive non-Hodgkin’s lymphomas (NHL), has rarely been reported in indolent lymphomas. Large series have reported this complication in 3 % of indolent NHLs, generally following histologi-cal transformation. Patients and methods: We retrospectively reviewed the disease characteristics and clinical course in seven patients (six females, one male) with indolent B-cell lymphomas who developed CNS involvement during various stages of their illness. Results: The median ages at diagnosis of systemic and CNS lymphoma were 60 and 63 years, respectively. Histologies were: small lymphocytic lymphoma (two), follicular lymphoma grade I (two), follicular lymphoma grade II (two) and unclear low-grade histology (one). There were diverse neurological symptoms. Two patients had parenchymal involvement, three had leptomeningial invol-vement and two had both. Systemic lymphoma was found in all patients, all but one having bone marrow involvement. Four patients had a transformation to high-grade histology. Six patients were treated with systemic and intra-cerebrospinal fluid chemotherapy, and two received radiotherapy as well. Five patients achieved CNS response. Survival was 1–9 years for treated patients (median 2 years). Three patients died of CNS disease. Conclusions: CNS involvement is a rare and unexpected complication of indolent NHL, which should be considered in the differential diagnosis of patients presenting with new neurological signs. This condition is treatable and some patients have a long clinical course. Key words: central nervous system, clinical course, indolent, non-Hodgkin’s lymphom