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Objective The clinical, imaging and pathological manifestations of one patient at different stages of primary central nervous system lymphoma (PCNSL) have been analyzed to disclose its pathogenesis. Methods and Results A 29-year-old female patient showed recurrent onsets. On the first onset, the main clinical manifestation was blurred vision and visual field defect. Cranial MRI showed a patchy lesion in the right parietal and occipital lobes without obvious occupying sign. T1WI showed slight low-intensity sign, T2WI and FLAIR showed high-intensity signs. Enhanced scanning showed heterogeneous punctate enhancement. The lesion disappeared gradually after glucocorticoid impact therapy. Headache, vomiting and left limb paralysis were the main clinical manifestations on the second onset, and MRI showed a lesion in the right frontal and parietal lobes with obvious occupying sign and solid enhancement, low- intensity on T1WI, high-intensity on T2WI and FLAIR. The tumor was totally removed under microscope. Histological findings showed large tumor cells, rich cytoplasm, nuclei with various sizes and shapes, conspicuous mitosis, patchy necrosis, and interstitial small vessel hyperplasia. Immunohistochemical staining showed that membrane of tumor cells was positive for CD20, and nuclei were positive for paired box gene 5 (PAX5) and multiple myeloma oncogene 1 (MUM1). In a few tumor cells, membrane was positive for CD10 and CD30, and nuclei were positive for cyclin D1. Besides, tumor cells were negative for CD3, anaplastic lymphoma kinase (ALK) and glial fibrillary acidic protein (GFAP). Ki-67 labeling index was about 80%. EBER in situ hybridization (ISH) assay showed that mRNA coded by Epstein-Barr (EB) virus was negative. The tumor showed angiotropic characteristics, and the walls of involved blood vessels were wrapped and destructed. The final diagnosis was confirmed as diffuse large B cell lymphoma. Conclusions PCNSL has various imaging features, revealing as diffuse infiltrating or solid occupying lesions, which emerge as the result of its angiotropic characteristics. [ABSTRACT FROM AUTHOR]

In this paper, we have reviewed the central nervous system (CNS) lymphatic circulation and related diseases. The lymphatic system is an important component of circulatory system. However, classic lymphatic vessels consisted of endotheliocytes are not found within CNS. Indeed, the central lymphatic circulation exists. Virchow - Robin space (VRS) is regarded as main component of the central lymphatic circulation, which resembles peripheral lymphatic system functionally and plays an important role in the regulation of CNS homeostasis. VRS plays the function of central lymphatic drainage, through which the macromolecular substances in cerebral interstitial fluid are cleared. Also, VRS is the main part of immune surveillance system. The central lymphatic circulation works crucially in the development of related diseases within CNS, such as lymphostatic encephalopathy, demyelinating diseases, CNS neoplasms, CNS infections, protein conformational diseases, etc. [ABSTRACT FROM AUTHOR]

Objective: To investigate the feasibility of continuous intraspinal ceftazidime administration for treatment of purulent meningitis due to Achromobacter infection., Methods: A patient with established diagnosis of purulent meningitis due to Achromobacter infection was admitted, who failed to respond favorably to a 3-day ceftazidime treatment administered intravenously. Continuous intraspinal ceftazidime administration at the dose of 0.2 g/d was then attempted through a catheter placed in the cisterna magna in addition to intravenous ceftazidime for 3 days, which resulted in obvious relief of the symptoms. The catheter was subsequently withdrawn, and the patient received further treatment with additional intravenous ceftazidime for a week., Results: The symptoms of purulent meningitis was significantly improved after a 3-day continuous intraspinal ceftazidime administration, and the patient was eventually cured after completion of the treatment course. Intrathecal ceftazidime was also attempted previously but failed due to intolerance of pains in the legs. No relapse was observed in this case 3 months after the discharge., Conclusion: Continuous intraspinal ceftazidime administration can be effective and safe for treatment of purulent meningitis.

Objective: To observe the expression of glucose transporter 1 (GLUT1) in the blood-brain barrier around the hematoma in rats with cerebral hemorrhage., Method: Brain tissue around the hematoma in rats with cerebral hemorrhage was prepared for GLUT1 detection by immunohistochemistry., Result: The expression of GLUT1 upregulated within 48 h after cerebral hemorrhage and downregulated afterwards., Conclusion: Protective reaction of the blood-brain barrier can be initiated to ensure glucose supply to the neurons against the injury by cerebral hemorrhage.