Case report of unusual leukoencephalopathy preceding primary CNS lymphoma

A previously healthy 35 year old woman presented with bilateral uveitus ass ociated with multiple, evolving, non-enhancing white matter lesions consist ent with a progressive leukoencephalopathy such as multiple sclerosis. Thir ty months after her initial presentation, she was diagnosed with primary CN S lymphoma and died 14 months later. The unusual clinical course preceding the diagnosis suggests that a demyelinating disease may have preceded, and possibly heralded, the development of primary CNS lymphoma. Cases of "senti nel lesions" heralding the diagnosis of primary CNS lymphoma have been repo rted, and this case further corroborates such instances and raises further issues regarding possible neoplastic transformation occurring in inflammato ry diseases such as multiple sclerosis.