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酷似医源性克雅氏病的脑淋巴瘤病

Lymphomatosis cerebri mimicking iatrogenic Creutzfeldt-Jakob disease.

作者信息

Rivero Sanz Elena, Torralba Cabeza Miguel Ángel, Sanjuán Portugal Francisco, García-Bragado Federico

机构信息

Department of Neurology, Hospital Clinico Universitario Lozano Blesa, Zaragoza, Spain.

Department of Internal Medicine, Hospital Clinico Universitario Lozano Blesa, Zaragoa, Spain.

出版信息

BMJ Case Rep. 2014 Sep 8;2014:bcr2013201246. doi: 10.1136/bcr-2013-201246.

Abstract

Lymphomatosis cerebri (LC) is a rare variant of primary central nervous system lymphoma (PCNSL) whereby individual lymphoma cells infiltrate the cerebral white matter without causing a mass effect. The disease characteristically presents as a rapidly progressive dementia, which opens an ample differential diagnosis of toxic, metabolic, neurodegenerative and infective causes. Other presentations also include changes in personality, myoclonus and psychotic symptoms. Here we report a patient who presented with a rapidly progressive dementia with a unique surgical history of a dural mater graft in the 1970s. The diagnosis of iatrogenic Creutzfeldt-Jakob disease (iCJD) was initially considered. However, the patient's clinical status deteriorated rapidly with no response to symptomatic treatment and she died 2 months after symptom onset. A diagnosis of T-type LC was reached at autopsy.

摘要

脑淋巴瘤病(LC)是原发性中枢神经系统淋巴瘤(PCNSL)的一种罕见变体,单个淋巴瘤细胞浸润脑白质而不产生占位效应。该疾病的典型表现为快速进展性痴呆,这引发了对中毒、代谢、神经退行性和感染性病因的广泛鉴别诊断。其他表现还包括人格改变、肌阵挛和精神症状。在此,我们报告一名患者,其表现为快速进展性痴呆,有20世纪70年代硬脑膜移植的独特手术史。最初考虑诊断为医源性克雅氏病(iCJD)。然而,患者的临床状况迅速恶化,对症治疗无效,症状出现后2个月死亡。尸检确诊为T型LC。

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