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Meningeal Mycosis Fungoides: Clinical and Cellular Characteristics
- THOMAS W. HAUCH, M.D.;
- JOHN D. SHELBOURNE, M.D., Ph.D.;
- HARVEY J. COHEN, M.D.;
- DAVID MASON, M.D.; and
- WILLIAM B. KREMER, M.D.
Abstract
A patient with mycosis fungoides developed meningeal disease while his skin disease was in remission with systemic chemotherapy. His central nervous system involvement with mycosis fungoides was controlled with intrathecal methotrexate for 7 months. The proliferating cells recovered from the spinal fluid showed similarities to the Sézary cell by light and electron microscopy. Surface receptor studies suggested that these cells were lymphoid cells of thymic derivation. Although mycosis fungoides has been shown to spread to the central nervous system in autopsied cases, reports of clinical neurologic disease are rare, and in only one earlier report have malignant cells been found in the spinal fluid. Thus, as in other lymphoproliferative disorders, prompt consideration of meningeal involvement in a patient exhibiting neurologic symptoms while in peripheral remission may allow earlier treatment of this complication.
Article and Author Information
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▸From the Departments of Medicine and Pathology, Veterans Administration Hospital and Duke University Medical Center, Durham, North Carolina.
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Grant support: Veterans Administration Research Program (4980-01), Veterans Administration Electron Microscopy Laboratory, and Public Health Service Research Grant CA-05634 from the National Cancer Institute.
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▸Requests for reprints should be addressed to William B. Kremer, M.D., Chief, Section of Hematology, VA Hospital, Durham, NC 27705.
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- Received June 28, 1974.
- Accepted December 6, 1974.
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