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Patients with solid LMM present mostly with spinal or radicular symptoms (53%), whereas patients with hematologic LMM more often show cranial nerve dysfunction at presentation (53%). Multifocal neurologic symptoms were seen in 67% of patie nts. The first CSF cytology demonstrated malignant cells more frequently in solid LMM compared with hematologic LMM (73% versus 53%). Extralumbar punctures increased the sensitivity of cytology to a greater extent in hematologic LMM than in solid LMM (3 4% versus 10%). Abnormal neuroimaging findings were found more often in solid LMM than in hematologic LMM (67% versus 40%). In creased total CSF protein in combination with either multifocal neurologic symptoms or abnormal neuroimaging findings was fou nd in 73% of patients with a negative first CSF cytology. Patients with LMM presented differently depending on the histology of the primary tumor. In patients with a negative first CSF cytologic examination, multiple lumbar punctures increased the diagn ostic accuracy, especially in hematologic LMM. LMM could also be diagnosed in patients with known cancer if total CSF protein was increased in combination with either multifocal neurologic symptoms or abnormal neuroimaging findings, preferably MRI. |
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blood dyscrasias,neurologic findings with
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cerebrospinal fluid
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cerebrospinal fluid,cytology
cranial neuropathy
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lymphoma
meningeal enhancement
meningitis,carcinomatous
meningitis,leukemic
meningitis,lymphomatous
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MRI,abnormal
neurologic disease,diagnoses of
radiculopathy
review article
root lesion,nerve
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