# A Mystery in a Case: Unraveling the Complexity of Bing-Neel Syndrome

## TL;DR

This case study explores a rare complication of a type of lymphoma called Bing-Neel syndrome in a patient with a complex medical history.

## Contribution

The paper presents a unique case of Bing-Neel syndrome with diagnostic and therapeutic challenges despite normal MRI findings.

## Key findings

- The patient had clinical symptoms of Bing-Neel syndrome despite no MRI abnormalities.
- The patient had a history of Waldenström’s macroglobulinemia and Agent Orange exposure.
- The case highlights the difficulty in diagnosing and treating Bing-Neel syndrome.

## Abstract

Waldenström’s macroglobulinemia (WM) is a B-cell non-Hodgkin’s lymphoma characterized by clonal IgM-secreting lymphoplasmacytic cell proliferation. Bing-Neel syndrome (BNS) is a rare complication of WM that results in the infiltration of the central nervous system (CNS) with IgM-secreting lymphoplasmacytic cells. This case study presents a 75-year-old Caucasian male with a history of WM and Agent Orange exposure who ultimately was diagnosed with BNS. This patient posed unique diagnostic challenges as the patient experienced clinical symptoms despite the absence of MRI abnormalities and therapeutic challenges.