Primary central nervous system diffuse large B-cell lymphoma with MYC and BCL2 rearrangements associated with deep brain stimulation device

Kirill A Lyapichev; Sri Bharathi Kavuri; Patrick J Karas; Laura Wu; Nahyun Jo; John Heymann; Hadi Yaziji; Jianli Dong; Farkhod Tursunbaev; Rasha Alfattal; Michelle Madden Felicella

doi:10.1007/s00428-024-03948-9

Primary central nervous system diffuse large B-cell lymphoma with MYC and BCL2 rearrangements associated with deep brain stimulation device

Virchows Arch. 2024 Oct 18. doi: 10.1007/s00428-024-03948-9. Online ahead of print.

Authors

Affiliations

¹ Department of Pathology, University of Texas Medical Branch, Galveston, TX, USA. kirill.lyapichev@gmail.com.
² Department of Pathology & Laboratory Medicine, Cleveland Clinic Florida, 2950 Cleveland Clinic Boulevard, Weston, FL, 33331, USA. kirill.lyapichev@gmail.com.
³ Department of Pathology, University of Texas Medical Branch, Galveston, TX, USA.
⁴ Department of Neurosurgery, University of Texas Medical Branch, Galveston, TX, USA.
⁵ Department of Neurology, University of Texas Medical Branch, Galveston, TX, USA.
⁶ Department of Radiology, University of Texas Medical Branch, Galveston, TX, USA.
⁷ Vitro Molecular Laboratories, Miami, FL, USA.

^# Contributed equally.

PMID: 39422775
DOI: 10.1007/s00428-024-03948-9

Abstract

Primary central nervous system (CNS) diffuse large B-cell lymphoma with MYC and BCL2 rearrangements is a very rare lymphoma subtype. Deep brain stimulation is an effective minimally invasive therapeutic option for the treatment of refractory movement disorders, as well as some psychiatric disorders and chronic pain syndromes. Herein, we report a case of CNS lymphoma, which developed around an electrode of a deep brain stimulation (DBS) device. A 70-year-old woman with drug-resistant essential tremor was treated with bilateral thalamic DBS with significant symptomatic improvement over the following year. She presented to the emergency department with recurrent tremor, blurred vision, and confusion. Imaging showed a 4 cm heterogeneously enhancing centered around the DBS electrode. Pathologic evaluation and systemic workup confirmed a diagnosis of primary CNS diffuse large B-cell lymphoma. MYC and BCL2 rearrangements were identified. To our knowledge, this is the first reported case of a CNS lymphoma associated with a DBS electrode.

Keywords: CNS; DBS; Diffuse large B-cell lymphoma with MYC and BCL2 rearrangements.