Lymphomatoid granulomatosis of the central nervous system (CNS-LYG), immune thrombocytopenia, disseminated zoster and venous thrombosis: “Hickam’s dictum posing a management challenge”

We describe a case of isolated primary CNS lymphomatoid granulomatosis and a discordant low-grade B-cell lymphoma involving the bone marrow causing chronic immune thrombocytopenia. Clinical course was complicated with disseminated zoster and sub-massive pulmonary embolism. Our patient was successfully managed with a combination radioimmunotherapy strategy with rituximab and radiation therapy.