Background: Primary central nervous system lymphoma (PCNSL) is the most prevalent brain, spinal cord, eyes,\nand leptomeningeal lymphoma. It is often misdiagnosed due to an unspecific presentation or unavailable\nbiopsy and results in a poor prognosis. Although the craniocerebral imaging examination of PCNSL has some\ncharacteristics, it is limited, and atypical cases are especially difficult to identify with intracranial tumours and\nother diseases. The biopsy, as the gold standard for PCNSL diagnosis, is not eligible for all patients suspected\nof having PCNSL.\nCase presentation: This report documents a woman who presented with a three-month history of numbness\nand weakness in the right leg. She was treated with drugs at a local hospital for one month. She developed\ndemyelination lesions and her symptoms were aggravated. The patient was admitted to the Department of\nNerve Infection and Immunology at Tiantan Hospital. Head magnetic resonance imaging (MRI) enhanced\nscanning indicated significant inflammatory demyelinating disease, and lymphoma was not excluded. CSF\nrevealed a high protein level and CSF cytology detected abnormal cells, PCNSL was eventually presumed\naccording to positive CSF cytology and cytological detection of the cerebrospinal fluid flow.\nConclusions: PCNSL is a highly invasive tumour. With the development of technologies such as cerebrospinal\nfluid cytology and flow cytology, CSF analysis has become one of the definite diagnosis methods, and the\ntumour cell finding in CSF is the only reliable basis for diagnosis. Flow cytometric analysis and gene\nrearrangement testing also provide objective evidence.
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