Lymphomatous meningitis is a progressive disease caused by the spread of lymphoma (cancer of the lymph nodes or thymus) cells into the leptomeninges, the protective membrane of the brain and spinal cord.
The leptomeninges consists of the pia mater (thin tissue over the brain), the arachnoid (the membrane surrounding the pia mater) and the subarachnoid space (space between the arachnoid and the pia mater) along with the cerebrospinal fluid that fills the subarachnoid space and flows around the brain and spinal fluid.
Lymphomatous meningitis is a type of neoplastic meningitis, meaning malignant cells have invaded the leptomeninges via the cerebrospinal fluid and are transported through the central nervous system.
Causes and Symptoms of Lymphomatous Meningitis
Lymphomatous meningitis (LM) most often occurs as a complication of lymphoma from another area of the body. Malignant lymphocytes (white blood cells that have uncontrollable growth and reproduction) travel from the lymphoid tissue to the meninges of the brain and spinal cord.
Symptoms of lymphomatous meningitis often relate to where in the central nervous system (CNS) the cancer has spread to:
Nausea or vomiting
Memory issues or confusion
Vision issues such as double vision
Other symptoms of LM are associated with pressure on the spinal column:
Hemiparesis — paralysis or weakness on one side of the body
Neck or back pain
Bowel or bladder problems may be brought on by compression of the nerves in the lumbar spine from cauda equina syndrome, if the malignancy has spread through the spinal fluid and formed a solid mass on the spine
How Is Lymphomatous Meningitis Diagnosed?
Diagnosis of lymphomatous meningitis usually includes a neurological exam, imaging of the neuraxis (central nervous system) and lumbar punctures (spinal taps).
Magnetic resonance imaging (MRI) of the central nervous system and study of the circulation of the cerebrospinal fluid (CSF) will help your physician determine if you have any blockages that are interfering with the CSF flow and where the disease is located.
State-of-the-Art Treatments for Lymphomatous Meningitis at NSPC
Treatments for lymphomatous meningitis are intended to ease symptoms, help improve end-of-life care and prolong life expectancy. Research, including clinical trials, is ongoing to determine the best method to eliminate cancer cells from the central nervous system and cure lymphomatous meningitis.
Symptom-alleviating drugs may include: analgesics and opiates for pain relief, anticonvulsants to reduce seizures and antidepressants if necessary.
Radiation Therapy is designed to reduce the size of the lesions, alleviate some of the symptoms and hopefully improve the cerebrospinal fluid (CSF) flow.
Intrathecal Chemotherapy is chemotherapy delivered directly to the CSF, usually via a lumbar puncture in the spine or a ventricular reservoir in the brain.
Ventriculperitoneal Shunt If the malignant lymphocytes have caused a blockage of the CSF, an increase in intracranial pressure can result causing hydrocephalus—a buildup of CSF on the brain. A surgical operation to place a shunt to drain the fluid from the brain may be needed.
Neurological Surgery, P.C. (NSPC) has a multidisciplinary team of expert neurosurgeons, neurophysiologists, endovascular neuroradiologists, neuro-oncologists and neurophysiologists, with convenient offices on Long Island and NYC. As a leading neurosurgical practice in the New York region, NSPC has premier physicians in the specialties of interventional neuroradiology, neuro-oncology, pain management and critical care neurology for brain-related diseases and disorders.