An Aggressive Course of Transformed Splenic Diffuse Red Pulp Small B-Cell Lymphoma With Novel Somatic Loss-of-Function Mutation in RB1.

Splenic diffuse red pulp small B-cell lymphoma (SDRPL) is an extremely rare B-cell lymphoma. The disease is typically indolent and treatment with splenectomy usually results in durable remissions. Here, we present a case of an extremely aggressive course of SDRPL with transformation to diffuse large B-cell lymphoma and multiple relapses immediately following cessation of immunochemotherapy. We provide results from whole-exome sequencing from debut of SDRPL and from following transformed stages and identified a novel somatic mutation in RB1 as the possible driver of this aggressive disease, which has not been reported earlier in SDRPL.

[Subacute parkinsonism as first symptom of primary CNS lymphoma].

Secondary parkinsonism due to cerebral neoplasia is a rare condition. We present a case report of a 73-year-old woman with three weeks of progressing right-sided parkinsonism. Cerebral MRI arouse suspicion of left-sided primary CNS-lymphoma in the left basal ganglia. Cerebralspinal fluid analyzed with flow cytometry revealed diffuse B-cell lymphoma. The patient was transferred to the department of haematology and was treated by standard primary CNS-lymphoma protocol. Five-month clinical control revealed marked recovery. At nine-month control an MRI of cerebrum showed almost complete regression of tumour.