1例血管内淋巴瘤病伴发偏瘫及脑神经损害病例（2003年：4b）

A case of hemiparesis associated with cranial nerve lesions due to intravascular lymphomatosis(2003:4b).

作者信息

De Bruecker Y, Demaerel P, Wilms G, Sciot R, Ballaux F, Robberecht W

机构信息

Department of Radiology, University Hospitals, Catholic University of Leuven, Leuven, Belgium.

出版信息

Eur Radiol. 2003 Jul;13(7):1753-5. doi: 10.1007/s00330-003-1961-1.

DOI:10.1007/s00330-003-1961-1

PMID:12899134

Abstract

Intravascular lymphomatosis is a rare variant of non-Hodgkin's lymphoma with an unusual predilection for the central nervous system. Most cases are not diagnosed until postmortem because of variable clinical presentation and non-specific laboratory findings. We studied a 41-year-old lady who presented with progressive neurological symptoms. MR showed multifocal grey and white matter lesions. Brain biopsy showed an intravascular lymphoma of the B-cell lineage. This report illustrates the ischaemic origin of the radiological lesions, as they are all hyperintense on the diffusion-weighted images. This has, to our knowledge, never been published before. MR did not show any enhancement after intravenous Gadolinium-DTPA (parenchymal or meningeal)which is a very uncommon finding in this entity. Intravascular lymphomatosis should be taken into account in the differential diagnosis of repeated cerebral ischemia of unclear aetiology.

摘要

血管内淋巴瘤是一种罕见的非霍奇金淋巴瘤变体，对中枢神经系统有异常偏好。由于临床表现多样且实验室检查结果不具特异性，大多数病例直到尸检时才被诊断出来。我们研究了一位出现进行性神经症状的41岁女性。磁共振成像（MR）显示多灶性灰质和白质病变。脑活检显示为B细胞系血管内淋巴瘤。本报告说明了这些放射学病变的缺血性起源，因为它们在扩散加权图像上均为高信号。据我们所知，这在以前从未被报道过。静脉注射钆喷酸葡胺（Gadolinium-DTPA）后，磁共振成像未显示任何强化（实质或脑膜），这在该疾病中是非常罕见的发现。在病因不明的反复脑缺血的鉴别诊断中应考虑血管内淋巴瘤。