Cerebral lymphoma in childhood: a diagnostic dilemma

A diffuse B cell lymphoma was recognized at autopsy in an otherwise healthy 3 1/2-year-old girl with a three-month history of recurrent seizures. This lymphoma, treated only by debulking, was found at autopsy to have originated in the right cerebral hemisphere and to have metastasized throughout the brain, the leptomeninges around the brain stem and cerebellum, and the ventricular system. Unusual features in this lymphoma included tumoral calcifications associated with necrosis, tumoral cystic changes, polyclonal tumor cells, and meningeal metastases.