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.
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:
Other symptoms of LM are associated with pressure on the spinal column:
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
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.
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.
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