Case 105

Welcome back!

During your on call as the haematology registrar on the 2nd January you are contacted by the neurosurgical team.  A 54 year gentleman had been referred into the tertiary centre from a local hospital over the Christmas holidays.  He had presented to his local hospital with weakness of the right arm and some “altered behaviour” over the previous week.  CT head on admission had shown an isolated cerebral mass with surrounding oedema.  Steroids had been administered prior to transfer.  Symptoms had shown some signs of improvement on arrival to the tertiary centre.

The neurosurgical team would like some input from haematology as the suspicion is that of CNS lymphoma.

What would you advise?

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