Chasing clues : Dementia unveils PML long after R‐CHOP treatment

PML is a very well known complication in immuno compromised patients, malignancy, and with disease modifying agents and chemotherapy agents. Here in we present a young male who had unsteadiness memory impairment, behavioral changes 3 year after being treated for NHL METHOD: 33 year male treated for NHL of the spine 5 cycles RT A and chemotherapy R CHOP regimen 3 years back, presented with 10 months of intertwines, 4 months of memory impatient, dis inhibition, apathy, perseverance, with optic ataxia, occulomotor apraxia, finger agnosia, fab 5/18, cerebellar signs RESULT: A possibility of CNS Lymphoma, Paraneoplastic syndrome, PML, Prion was considered and evaluated. Mri brain shows white matter hyperintensity in subcortical, pv, cerebellar with involvement of u fibers, CSF normal and JC virus DNA In CSF positive CONCLUSION: Though there are case reports of R CHOP induced PML during 3 cycle or 4th, this case is rare by means of having PML afer 3 years of treatment highlighting, dementia presenting as PML unmasked.