Rayfield Corbin, Mertz Lester, Kelemen Katalin, Aslam Fawad
Mayo Clinic, Phoenix, Arizona, USA.
BMJ Case Rep. 2019 Aug 26;12(8):e230753. doi: 10.1136/bcr-2019-230753.
A 68-year-old man, with a history of non-Hodgkin's lymphoma in remission, was admitted for homonymous hemianopsia, headaches and subacute progressive cognitive decline. Imaging revealed brain infarcts and angiography suggested vasculitis. A brain biopsy, however, revealed an intravascular large B-cell lymphoma (IVLBL). Central nervous system (CNS) vasculitis and IVLBL of the brain are extremely rare diseases that can have an almost identical clinical presentation. Angiographic findings are very similar but usually are reported as compatible with vasculitis. Brain biopsy or a random skin biopsy are crucial in diagnosing IVLBL as the accuracy of angiographic findings for CNS vasculitis is low.
一名68岁男性，有非霍奇金淋巴瘤缓解病史，因同向性偏盲、头痛和亚急性进行性认知衰退入院。影像学检查发现脑梗死，血管造影提示血管炎。然而，脑活检显示为血管内大B细胞淋巴瘤（IVLBL）。中枢神经系统（CNS）血管炎和脑IVLBL是极其罕见的疾病，临床表现几乎相同。血管造影结果非常相似，但通常报告为与血管炎相符。脑活检或随机皮肤活检对于诊断IVLBL至关重要，因为CNS血管炎血管造影结果的准确性较低。
