Diagnosis of primary meningeal natural killer/T‑cell lymphoma of the central nervous system using cerebrospinal fluid cytology: A case report

Oncol Lett. 2024 Dec 31;29(3):113. doi: 10.3892/ol.2024.14859. eCollection 2025 Mar.

Abstract

Primary central nervous system (CNS) lymphoma of the meninges is a rare tumor that originates in the meninges and does not show parenchymal or systemic spread. CNS involvement by natural killer (NK)/T-cell lymphoma accounts for only 2% of all extranodal NK/T-cell lymphomas, and primary NK/T-cell lymphoma of the meninges is even rarer. The present study reports a case of a 55-year-old male patient with primary NK/T-cell lymphoma. The patient presented with intermittent dizziness and headaches for the past 1 month prior to presentation. Magnetic resonance imaging of the head identified no overt abnormalities. However, cytological analysis of a Wright-Giemsa-stained cerebrospinal fluid (CSF) sample, demonstrated numerous atypical lymphocytes and lymphoma cells. Flow cytometry of the CSF was performed as an auxiliary method, and it showed that a large proportion of the cells in the CSF were of the NK/T-cell lineage, to indicating a diagnosis of NK/T-cell lymphoma. Mutations of 14 genes were detected, including JAK3 mutations, upon screening of the CSF for blood system diseases using next-generation sequencing. Therefore, the present study demonstrated that a CSF cytological examination may be an important component of the diagnostic workup for patients suspected to have a primary meningeal CNS lymphoma.

Keywords: cerebrospinal fluid; cytopathology; morphology of cerebrospinal fluid cells; primary lymphoma of the central nervous system; primary natural killer/T-cell lymphoma of the meninges.

Publication types

  • Case Reports

Grants and funding

The present study was supported by the Exploration and Innovation Projects of Xi'an Jiaotong University (grant no. xzy012022133), the Science and Technology Talent Support Program of Shaanxi Provincial People's Hospital (grant no. 022JY-56), and the Science and Technology Development Incubation Funding of Shaanxi Provincial People's Hospital (grant no. 2022YJY-24).