Ali Kabeer, Miatech Jennifer, Patel Falguni, Karan Abhinav, Quan Walter Jr
Internal Medicine, University of Florida College of Medicine - Jacksonville, Jacksonville, USA.
Hematology and Oncology, University of Florida College of Medicine - Jacksonville, Jacksonville, USA.
Cureus. 2025 Mar 26;17(3):e81250. doi: 10.7759/cureus.81250. eCollection 2025 Mar.
Marginal zone B-cell lymphoma (MZL) represents a heterogeneous group of indolent non-Hodgkin lymphomas (NHL) originating from the marginal zone of B cells in lymphoid tissues. Typically, MZL is classified as nodal, extranodal, and MZL with splenic involvement. Central nervous system (CNS) involvement is rare, whether it presents as a primary dural lymphoma or as a consequence of secondary CNS involvement. CNS involvement of MZL presents with non-specific symptoms such as headaches, focal neurological deficits, cognitive impairment, and seizures in the setting of mass effect. It is essential to consider new CNS infiltration as a possibility in patients with hematological malignancies who exhibit new neurologic symptoms. Herein, we present a case of a patient with a ventriculoperitoneal shunt and recently diagnosed with splenic MZL who presented with status epilepticus and was subsequently diagnosed with secondary CNS involvement, highlighting its associated diagnostic and therapeutic challenges.
边缘区B细胞淋巴瘤（MZL）是一组异质性的惰性非霍奇金淋巴瘤（NHL），起源于淋巴组织中B细胞的边缘区。通常，MZL分为淋巴结型、结外型和伴有脾脏受累的MZL。中枢神经系统（CNS）受累罕见，无论是表现为原发性硬脑膜淋巴瘤还是继发于中枢神经系统受累的结果。MZL的中枢神经系统受累表现为非特异性症状，如头痛、局灶性神经功能缺损、认知障碍以及在占位效应情况下的癫痫发作。对于出现新的神经系统症状的血液系统恶性肿瘤患者，必须考虑新的中枢神经系统浸润的可能性。在此，我们报告一例患者，该患者有脑室腹腔分流术，最近被诊断为脾脏MZL，出现癫痫持续状态，随后被诊断为继发中枢神经系统受累，突出了其相关的诊断和治疗挑战。
