From the Research
Yes, plasmablastic lymphoma can cause meningitis, as evidenced by a case report of primary CNS plasmablastic lymphoma with CSF cytology, flow cytometry, radiology, and histological correlation 1. This rare and aggressive type of non-Hodgkin lymphoma can spread to the central nervous system (CNS), including the meninges, resulting in lymphomatous meningitis. When plasmablastic lymphoma infiltrates the meninges, patients may experience symptoms such as:
- Headache
- Neck stiffness
- Mental status changes
- Nausea
- Vomiting
- Cranial nerve deficits Diagnosis typically involves cerebrospinal fluid (CSF) analysis through lumbar puncture, which may reveal malignant cells, elevated protein levels, and decreased glucose levels. Neuroimaging such as MRI with contrast can help identify meningeal enhancement or other CNS involvement. Treatment often includes high-dose systemic chemotherapy with CNS-penetrating agents like methotrexate or cytarabine, intrathecal chemotherapy, and sometimes radiation therapy, as seen in a case report where a patient with advanced AIDS and plasmablastic lymphoma achieved complete response with the V-EPOCH regimen and intrathecal chemotherapy 2. Plasmablastic lymphoma has a high propensity for CNS involvement due to its aggressive nature and is more common in immunocompromised individuals, particularly those with HIV infection, which is why CNS prophylaxis is often considered in the initial treatment approach for these patients 3.