Open Access Case report

Intravascular CNS lymphoma: Successful therapy using high-dose methotrexate-based polychemotherapy

Sied Kebir1, Klaus Kuchelmeister3, Pitt Niehusmann3, Michael Nelles2, Young Kim4, Sharmilan Thanendrarajan4, Niklas Schäfer1, Moritz Stuplich1, Frederic Mack1, Björn Scheffler5, Horst Urbach2, Martin Glas15 and Ulrich Herrlinger1*

Author Affiliations

1 Division of Clinical Neurooncology, Department of Neurology, University of Bonn Medical Center, Bonn, Sigmund-Freud-Straße 25, 53127 Bonn, Germany

2 Department of Radiology, University of Bonn Medical Center, Bonn, Sigmund-Freud-Straße 25, 53127 Bonn, Germany

3 Department of Neuropathology, University of Bonn Medical Center, Bonn, Sigmund-Freud-Straße 25, 53127 Bonn, Germany

4 Department of Oncology, University of Bonn Medical Center, Bonn, Sigmund-Freud-Straße 25, 53127 Bonn, Germany

5 Stem Cell Pathologies, Institute of Reconstructive Neurobiology, University of Bonn Medical Center, Bonn, Sigmund-Freud-Straße 25, 53127 Bonn, Germany

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Experimental Hematology & Oncology 2012, 1:37  doi:10.1186/2162-3619-1-37

Published: 5 December 2012

Abstract

Intravascular diffuse large B-cell lymphoma limited to the CNS (cIVL) is a very rare malignant disorder characterized by a selective accumulation of neoplastic lymphocytes (usually B cells) within the lumen of CNS blood vessels but not in the brain parenchyma. In the past, treatment of cIVL with anthracycline-based regimens was unsatisfactory with very short survival times. In the case of cIVL presented here, high-dose methotrexate-based polychemotherapy according to the Bonn protocol plus rituximab therapy was successful and led to a complete clinical and MRI remission which is ongoing 29 months after diagnosis.

Keywords:
Intravascular lymphoma; Intravascular CNS lymphoma; High-dose methotrexate-based polychemotherapy; Angioendotheliomatosis; Angiotropic lymphoma