{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T17:37:35Z","timestamp":1773769055561,"version":"3.50.1"},"reference-count":7,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2016,4,3]]},"abstract":"<jats:p>We report a case of a 58-year-old woman who presented with a 1-month course of progressive lower and upper extremity weakness in addition to binocular diplopia. Diagnostic lumbar puncture revealed atypical lymphoid cells with 28% blasts. Immunophenotype was consistent with B cell acute lymphoblastic leukaemia (B-ALL). Further work up showed no systemic involvement but extensive thoracolumbar-sacral leptomeningeal disease. The patient was treated with several courses of intrathecal and systemic chemotherapy followed by craniospinal irradiation for consolidation. There was initial steady improvement in neurological symptoms and leptomeningeal disease, the latter being ascertained through radiological studies and cerebrospinal fluid examination. After 10\u2005months of response, the patient relapsed with central nervous system (CNS) and systemic disease. B-ALL is a rare precursor lymphoid neoplasm that generally presents with systemic disease. While CNS involvement is not uncommon, isolated involvement of this compartment without systemic disease is exceedingly rare.<\/jats:p>","DOI":"10.1136\/bcr-2016-214645","type":"journal-article","created":{"date-parts":[[2016,4,19]],"date-time":"2016-04-19T08:52:57Z","timestamp":1461055977000},"page":"bcr2016214645","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Initial presentation of CNS-restricted acute lymphoblastic B cell leukaemia as peripheral polyneuropathy"],"prefix":"10.1136","volume":"2016","author":[{"given":"Guilherme","family":"Piovezani Ramos","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jose C","family":"Villasboas Bisneto","sequence":"additional","affiliation":[{"name":"Division of Hematology, Mayo Clinic, Rochester, Minnesota, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dong","family":"Chen","sequence":"additional","affiliation":[{"name":"Division of Hematology, Mayo Clinic, Rochester, Minnesota, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Animesh","family":"Pardanani","sequence":"additional","affiliation":[{"name":"Division of Hematology, Mayo Clinic, Rochester, Minnesota, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2016,4,19]]},"reference":[{"key":"2025082723045523000_2016.apr19_1.bcr2016214645.1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1096-8652(199912)62:4<234::AID-AJH6>3.0.CO;2-B"},{"key":"2025082723045523000_2016.apr19_1.bcr2016214645.2","doi-asserted-by":"crossref","unstructured":"Pui CH . Central nervous system disease in acute lymphoblastic leukemia: prophylaxis and treatment. Hematology Am Soc Hematol Educ Program 2006:142\u20136.","DOI":"10.1182\/asheducation-2006.1.142"},{"key":"2025082723045523000_2016.apr19_1.bcr2016214645.3","doi-asserted-by":"publisher","DOI":"10.1080\/10428190802311441"},{"key":"2025082723045523000_2016.apr19_1.bcr2016214645.4","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.41.1.95"},{"key":"2025082723045523000_2016.apr19_1.bcr2016214645.5","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)62187-4"},{"key":"2025082723045523000_2016.apr19_1.bcr2016214645.6","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2005-11-4666"},{"key":"2025082723045523000_2016.apr19_1.bcr2016214645.7","doi-asserted-by":"publisher","DOI":"10.4084\/mjhid.2014.075"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2016-214645","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T06:05:02Z","timestamp":1756361102000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2016-214645"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,4,19]]},"references-count":7,"alternative-id":["10.1136\/bcr-2016-214645"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2016-214645","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,4,19]]}}}