Thanks for the follow up, I will answer shortly
you make several points. first of all, elevated lymphocytes is usually indicative of a viral meningitis
, though it is also elevated with metastatic meningitis. however, usually cancer cells will be found in the cerebrospinal fluid
, and that would have been seen right away. the CT should show inflammation on the meninges
, which also would suggest metastatic meningitis.
in addition, metastatic disease would not get better at all unless it was treated with chemotherapy
, usually given interathecally (straight into the spinal fluid). although it usually happens in more advanced disease, it can occur even in people with disease that was thought to be localized.
I don't think you are missing anything, as you are very informed regarding her situation. please let me know if I can help further.