CASE REPORTPrimary Central Nervous System Cytotoxic/Suppressor T-Cell Lymphoma: Report of a Unique Case and Review of the LiteratureLiu, Dating M.D., Ph.D.; Schelper, Robert L. M.D., Ph.D.; Carter, David A. M.D.; Poiesz, Bernard J. M.D.; Shrimpton, Anthony E. Ph.D.; Frankel, Bruce M. M.D.; Hutchison, Robert E. M.D.Author Information From the Department of Pathology (D.L.), University of Manitoba, Winnipeg, Manitoba, Canada; the Departments of Pathology (R.L.S., A.E.S., R.E.H.), Neurosurgery (D.A.C.), and Medicine (B.J.P.), SUNY Upstate Medical University, Syracuse, New York; and the Department of Neurosurgery (B.M.F.), University of Tennessee, Memphis, Tennessee, U.S.A. Address correspondence and reprint requests to Robert E. Hutchison, MD, Department of Pathology, SUNY Upstate Medical University, 750 E. Adams St., Syracuse, NY 13224, U.S.A.; e-mail: [email protected] The American Journal of Surgical Pathology: May 2003 - Volume 27 - Issue 5 - p 682-688 Buy Abstract Peripheral T-cell lymphoma primary to the central nervous system is a rare occurrence. The authors report a case of an 89-year-old woman who presented with a 3-month history of worsening confusion and recent onset of headache, nausea and vomiting, and upper limb tremors. Computed tomography and magnetic resonance imaging examinations demonstrated a 4.5-cm solitary brain mass in the right basal ganglia with compression along the ventricular system. No other lesion was found in the patient. Histologic and immunohistochemical studies of a stereotactic biopsy of the mass showed a T-cell lymphoproliferative lesion positive for CD3, CD8, CD57, and T-cell intracellular antigen 1 and negative for CD4, CD56, CD30, anaplastic lymphoma kinase, and CD20. A monoclonal T-cell receptor-[gamma] gene rearrangement was detected by polymerase chain reaction analysis of genomic DNA isolated from paraffin-embedded tumor tissue sections. These findings were consistent with peripheral T-cell lymphoma of cytotoxic/suppressor phenotype, resembling the phenotype of T-cell large granular cell leukemia. To the authors' best knowledge, this represents the first reported case of primary brain T-cell lymphoma with a cytotoxic/suppressor immunophenotype. A brief review of the literature of primary brain T-cell lymphoma is also presented. Copyright © 2003 Wolters Kluwer Health, Inc. All rights reserved.