LYMPHOMATOUS MENINGITIS IN AIDS-RELATED SYSTEMIC NON-HODGKINS-LYMPHOMA - A REPORT OF 8 CASES

Meningeal involvement occurred in eight (22%) of 36 adult patients wit h AIDS-related systemic non-Hodgkin's lymphoma, seen over a 10-year pe riod. CLinical symptoms consisted of cranial nerve palsies, radicular involvement, headache or diffuse encephalopathy. CSF examination estab lished the diagnosis in all cases. Systemic disease had been diagnosed seven to 33 weeks before lymphomatous meningitis in six patients, whe reas in the remaining two patients diagnoses of systemic and meningeal disease were made simultaneously. All patients had intermediate or hi gh grade lymphomas and widespread disease. In to non-AIDS related lymp homas, marrow involvement at initial staging cannot be used to select patients for prophylactic treatment, as seven of our eight patients ha d no initial bone marrow involvement. In this restrospective review, p rognosis of lymphomatous meningitis was extremely poor, with a mean su rvival of only five weeks. Survival of patients with systemic lymphoma who eventually developed lymphomatous meningitis was 4.0 months compa red with 7.2 months for those who did not. Lymphomatous meningitis app ears to have the worst outcome of all AIDS-related neurological compli cations, regardless of treatment.