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/mm^3 (97% lymphocytes); RBC 0/mm^3; 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/mm^3 (50% lymphocytes); RBC 0/mm^3; 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/mm^3 (87% monocyte); RBC 10/mm^3; 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

CSF: cerebrospinal fluid; MRI: magnetic resonance imaging; WBC: white blood cell; RBC: red blood cell.