Case Report
Three Cases of Neoplastic Meningitis Initially Diagnosed with Infectious Meningitis in Emergency Department
Table 1
Summary of 3 cases of neoplastic meningitis.
| Case | Complaints | Initial diagnosis | Initial CSF study | Positive malignant cell | MRI | Final diagnosis |
| 68/M | Headache for 3 months | Tuberculous meningitis | Opening pressure 15 cm H2O WBC 110/mm3 (97% lymphocytes) RBC 0/mm3 Protein 419.3 mg/dL Glucose 4 mg/dL Adenosine deaminase 12 U/L Cytospin: no malignant cell | 3rd CSF | Leptomeningeal enhancement without parenchymal lesion | Nonsmall cell lung cancer with leptomeningeal carcinomatosis | 57/M | Headache for 3 weeks, diplopia | Aseptic meningitis | Opening pressure 33 cm H2O WBC 26/mm3 (50% lymphocytes) RBC 0/mm3 Protein 48 mg/dL Glucose 74 mg/dL Cytospin: no malignant cell | 2nd CSF | No abnormal finding | Advanced gastric cancer with leptomeningeal carcinomatosis | 75/M | Headache for 4 months, recurrent seizure | Unspecified meningitis | Opening pressure 9.5 cm H2O WBC 120/mm3 (87% monocyte) RBC 10/mm3 Protein 94.6 mg/dL Glucose 70 mg/dL Cytospin: 4% malignant cell | 1st CSF | Leptomeningeal enhancement in posterior fossa without parenchymal lesion | Leptomeningeal carcinomatosis with unknown primary focus |
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CSF: cerebrospinal fluid; MRI: magnetic resonance imaging; WBC: white blood cell; RBC: red blood cell.
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