Journal of Medical Cases, ISSN 1923-4155 print, 1923-4163 online, Open Access
Article copyright, the authors; Journal compilation copyright, J Med Cases and Elmer Press Inc
Journal website https://jmc.elmerpub.com

Case Report

Volume 16, Number 6, June 2025, pages 195-200


Successful Treatment of Primary Central Nervous System T-Cell Lymphoma With Induction Chemotherapy Followed by Consolidation With High-Dose Chemotherapy and Autologous Stem Cell Rescue

Figures

↓  Figure 1. MRI of the patient’s brain before and after HDC-ASCT. At the time of diagnosis of PCNSTL, the patient had a lesion in the left cerebellum on T1 + Gd (a), with significant vasogenic edema evident on T2 FLAIR (c). At 1 year following HDC-ASCT, the patient has complete resolution of both the area of the primary cerebellar lesion (b) as well as total resolution of vasogenic edema (d). FLAIR: fluid-attenuated inversion recovery; HDC-ASCT: high-dose chemotherapy followed by autologous stem cell transplantation; MRI: magnetic resonance imaging; PCNSTL: primary CNS T-cell lymphoma.
Figure 1.
↓  Figure 2. Hematoxylin and eosin (H&E) stain. Stained sections reveal fragments of brain parenchyma with a diffuse infiltrate of large atypical lymphoid cells. Mitotic figures are evident (a, × 100 magnification; b, × 400 magnification). Scattered cells exhibit morphologic features consistent with hallmark cells (c, arrows).
Figure 2.
↓  Figure 3. Phenotypic characterization by immunohistochemical (IHC) analysis, × 100 magnification. See Table 1 for additional IHC findings.
Figure 3.
↓  Figure 4. Clinical timeline of case. A patient with initial stroke-like symptoms was found to have PCNSTL. She underwent HDC-ASCT and is currently in complete remission with resolution of symptoms and restoration of normal functional status at approximately 18 months after HDC-ASCT. HDC-ASCT: high-dose chemotherapy followed by autologous stem cell transplantation; PCNSTL: primary CNS T-cell lymphoma. Created in BioRender. Holley, N. (2025) https://BioRender.com/kdfox90.
Figure 4.

Table

↓  Table 1. Additional Immunohistochemical and in situ Hybridization Results
 
Positive markers Negative markers
EBER ISH: Epstein-Barr virus-encoded RNA in situ hybridization.
CD2 (weak) CD5
CD4 (minor subset) CD8
CD7 CD10
CD43 CD15
CD56 (weak) CD34
Ki67 (> 95%) CD138
PD1 (subset) EBER ISH
TIA1 EMA
PAX5
p63