High incidence of primary cerebral lymphoma in tumor-induced central neurogenic hyperventilation
R. Pauzner, M. Mouallem, M. Sadeh, R. Tadmor and Z. Farfel
Department of Medicine E, Chain Sheba Medical Center, Tel Hashomer, Israel.
An awake patient presented with central neurogenic hyperventilation induced
by a cerebral tumor. Corticosteroid therapy and brain irradiation while the
patient was anesthetized and respiration controlled under
pancuronium-induced respiratory paralysis were followed by tumor regression
and resolution of hyperventilation. Recurrence of tumor 6 weeks later was
not accompanied by recurrence of hyperventilation. Cytologic study of
cerebrospinal fluid revealed B-cell lymphoma. This patient brings to 10 the
number of cases recorded with tumor-induced central neurogenic
hyperventilation. Five of the eight patients with known tumor histology had
a primary cerebral lymphoma, a rare neoplasm that comprises only 1% of all
intracranial neoplasms. The disproportionately high frequency of central
neurogenic hyperventilation in patients with cerebral lymphoma has
therapeutic implications that are briefly reviewed.