Bekkaoui Rayane, Tabati Salma, Sif Nasr Karima, El Bakkari Asaad, Laamrani Fatima Zahra, Omor Youssef, Latib Rachida, Amalik Sanae.
Journal: Medpeer Publisher
ISSN: 3066-2737
Volume: 3
Issue: 9
Date of Publication: 2026/09/07
Mantle cell lymphoma (MCL) is an uncommon B-cell non-Hodgkin lymphoma in which central nervous system (CNS) involvement is rare and associated with a poor prognosis. We report the case of a 71-year-old man with recently diagnosed stage IV blastoid mantle cell lymphoma who developed progressive drowsiness, confusion, and personality changes one month after diagnosis. Cerebrospinal fluid analysis was negative for malignant cells and infection. Brain magnetic resonance imaging demonstrated bilateral leptomeningeal abnormalities, including left temporal leptomeningeal thickening with post-contrast enhancement and right parasagittal parietal gyriform leptomeningeal thickening, without an associated intraparenchymal mass. In the context of known aggressive systemic lymphoma, these findings were highly suggestive of secondary leptomeningeal CNS involvement. The patient’s clinical condition rapidly deteriorated despite reduced-intensity chemotherapy, and he died approximately one week after the diagnosis of CNS involvement. This case highlights the aggressive behavior of the blastoid variant of MCL and emphasizes the crucial role of contrast-enhanced MRI in detecting secondary leptomeningeal involvement, particularly when cerebrospinal fluid cytology is initially negative.
Mantle cell lymphoma, blastoid variant, central nervous system lymphoma, leptomeningeal involvement, leptomeningeal enhancement, magnetic resonance imaging, secondary CNS lymphoma.
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