The 500th case: pain in both hip joints, headache, and diplopia
10.3760/cma.j.cn112138-20220220-00129
- VernacularTitle:第500例——双髋关节疼痛、头痛、复视
- Author:
Nannan ZHANG
1
;
Yanlong DUAN
;
Hui WANG
;
Ningning ZHANG
;
Jing YANG
;
Meng ZHANG
;
Nan LI
;
Shuang HUANG
;
Nan ZHANG
;
Ling JIN
Author Information
1. 国家儿童医学中心 首都医科大学附属北京儿童医院肿瘤内科 儿童肿瘤中心 儿童血液病与肿瘤分子分型北京市重点实验室 儿童肿瘤国家临床重点专科 儿科重大疾病研究教育部重点实验室，北京100045
- Keywords:
Child;
Lymphoma;
Diagnosis;
Treatment
- From:
Chinese Journal of Internal Medicine
2023;62(2):232-236
- CountryChina
- Language:Chinese
-
Abstract:
A male child, aged 5 years and 3 months, was admitted to the Oncology Department with a history of pain in both hip joints, headache, and diplopia lasting for 40 days. Physical examination did not reveal definitive signs or obvious abnormalities in the nervous system. Imaging studies showed only abnormalities in the craniocerebrum and spinal cord. Routine cerebrospinal fluid (CSF) analysis revealed elevation in the total number of white blood cells, mainly mononuclear cells. Biochemical analysis of CSF showed normal glucose and chloride levels, and increased protein concentrations. The possibility of central nervous system (CNS) infection was initially considered. Subsequently, antibacterial and antiviral therapy was administered; however, this treatment was ineffective. Further examination of CSF through immunophenotyping revealed mature B-cell lymphoma with CNS involvement; there were no neoplastic lesions detected elsewhere in the body. Thus, the patient was diagnosed with primary central nervous system lymphoma (PCNSL). Complete remission was achieved after chemotherapy with the CNCL-2017-mature B-cell lymphoma regimen. Thus far, all chemotherapy cycles have been completed, the patient remains in complete remission, and the follow-up is ongoing. Clinicians should pay close attention to PCNSL in children.
