Concurrent Neurological Involvement in Chronic Lymphocytic Leukemia: A Rare Case with Brain and Spinal Manifestations

Background and importance: Chronic lymphocytic leukemia (CLL) is the most common lymphoproliferative disorder in the United States. CLL invasion to the central nervous system (CNS) is a scarce complication followed by diverse outcomes. Moreover, symptomatic CNS lesion as the primary clinical presentation of undiagnosed CLL is extremely rare. In CNS involvements, it usually invades leptomeningeal, and less commonly causes parenchymal lesions. Case Presentation: We introduce 71 years 71-year-old man with a history of CLL referred to our center with headache and lower extremities weakness CNS involvement. After the initial evaluation, the MRI findings revealed a “ring or target sign” both in the temporal lobe and intramedullary spinal cord according to T9-T10. Surgical resection of the temporal lesion was done and CLL was confirmed with histological findings. Conclusion: Finally, the primary presentation of CLL with CNS involvement is an uncommon occurrence. It doesn’t show a preference for age, gender, or ethnicity and can occur at any stage of CLL. Therefore, it is important to be aware of this possibility when patients with a history of CLL present with neurological symptoms