Asymptomatic central pontine myelinolysis without hyponatriemia in diffuse large B cell lymphoma

We report here the accidental finding of a transient central pontine myelinolysis (CPM)-like brain lesion in an asymptomatic diffuse large B cell lymphoma patient. We could not find any significant electrolyte disturbance and we think as unlikely any drug-related effect. Besides simple casual association, we may conclude suggesting an interesting hypothesis: the lymphoma per se might predispose to minor CPM-like events, perhaps due to the activation of mediators (e.g., cytokines) that in the classical osmotic demyelination syndrome are usually operating downstream, following the initial well-known rapid osmotic changes