Abstract
Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS) is a rare central nervous system (CNS) disorder with distinct radiological features. However, CLIPEERS may mimic CNS lymphoma, and several cases in which CLIPPERS occurred premonitory to CNS lymphoma have been reported. We report a 31-year-old man presenting with progressive gait ataxia and the characteristic MRI features of CLIPPERS. He was diagnosed with stage II Hodgkin’s lymphoma at the age of 15, and we considered the possibility of newly emerged CNS lymphoma occurring in the immunosuppressive condition after the treatment of Hodgkin’s lymphoma. Histological findings showed no evidence of CNS lymphoma and the neurological symptoms were resolved by steroids. Although CLIPPERS developed in the reverse order in this case, CLIPPERS should be considered in different diagnosis for CNS lymphoma.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Pittock SJ, Debruyne J, Krecke KN, Giannini C, van den Ameele J, De Herdt V, et al. Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS). Brain. 2010;133:2626–34.
Limousin N, Praline J, Motica O, Cottier JP, Rousselot-Denis C, Mokhtari K, et al. Brain biopsy is required in steroid-resistant patients with chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS). J Neurooncol. 2012;107:223–4.
De Graaff HJ, Wattjes MP, Rozemuller-Kwakkel AJ, Petzold A, Killestein J. Fatal B-cell lymphoma following chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids. JAMA Neurol. 2013;70:915–8.
Taieb G, Uro-Coste E, Clanet M, Lassmann H, Benouaich-Amiel A, Laurent C, et al. A central nervous system B-cell lymphoma arising two years after initial diagnosis of CLIPPERS. J Neurol Sci. 2014;344:224–6.
Lin AW, Das S, Fraser JA, Ang LC, Florendo-Cumbermack A, Jenkins ME, et al. Emergence of primary CNS lymphoma in a patient with findings of CLIPPERS. Can J Neurol Sci. 2014;41:528–9.
Horibe K, Saito AM, Takimoto T, Tsuchida M, Manabe A, Shima M, et al. Incidence and survival rates of hematological malignancies in Japanese children and adolescents (2006–2010): based on registry data from the Japanese Society of Pediatric Hematology. Int J Hematol. 2013;98:74–88.
Ortega MR, Usmani N, Parra-Herran C, Adams DJ, Steingo B, Rammohan KW. CLIPPERS complicating multiple sclerosis causing concerns of CLS lymphoma. Neurology. 2012;79:715–6.
Symmonds M, Waters PJ, Kuker W, Leite MI, Schulz UG. Anti-MOG antibodies with longitudinally extensive transverse myelitis preceded by CLIPPERS. Neurology. 2015;84:1177–9.
Dalia S, Forsyth P, Chavez J, Price S, Shah B, Bello C, et al. Primary B-cell CNS lymphoma clinicopathologic and treatment outcomes in 89 patients from a single tertiary care center. Int J Hematol. 2014;99:450–6.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors have no conflict of interest to disclose.
About this article
Cite this article
Mashima, K., Suzuki, S., Mori, T. et al. Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS) after treatment for Hodgkin’s lymphoma. Int J Hematol 102, 709–712 (2015). https://doi.org/10.1007/s12185-015-1850-9
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12185-015-1850-9