Primary malignant lymphoma of the central nervous system presenting with ascites and pleural effusion

A 70-year-old woman was admitted to our hospital owing to ascites and pleur al effusion. Though malignant cells (B-cell type lymphoma) were detected in both the ascites and pleural effusion, neither lymph node swelling nor a t umor was detected upon chest, abdominal and pelvic computed tomography (CT) . After weekly THP-COP therapy for 8 weeks, the ascites and pleural effusio n completely disappeared. Two years after the first admission, she was re-a dmitted because of a disturbance of consciousness, and a brain tumor was de tected on CT scan. The immunohistological and genetic data for the brain tu mor were identical to those of the malignant cells in the pleural effusion and ascites detected 2 years previously. Whereas the symptoms at onset of a primary lymphoma of the central nervous system (CNS) are usually neurologi cal ones, in this ran: case of primary CNS lymphoma, the symptoms at onset were the ascites and pleural effusion without neurological symptoms.