脑血管造影显示的血管炎并不总是真正的血管炎：血管内大B细胞淋巴瘤可模仿中枢神经系统血管炎。
Vasculitis on brain angiography is not always vasculitis: intravascular large B-cell lymphoma mimicking central nervous system vasculitis.
作者信息
Rayfield Corbin, Mertz Lester, Kelemen Katalin, Aslam Fawad
机构信息
Mayo Clinic, Phoenix, Arizona, USA.
出版信息
BMJ Case Rep. 2019 Aug 26;12(8):e230753. doi: 10.1136/bcr-2019-230753.
Abstract
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.
摘要
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。
相似文献
1
Vasculitis on brain angiography is not always vasculitis: intravascular large B-cell lymphoma mimicking central nervous system vasculitis.脑血管造影显示的血管炎并不总是真正的血管炎：血管内大B细胞淋巴瘤可模仿中枢神经系统血管炎。
BMJ Case Rep. 2019 Aug 26;12(8):e230753. doi: 10.1136/bcr-2019-230753.
2
Central nervous system vasculitis: all that glitters is not gold.中枢神经系统血管炎：闪光的未必都是金子。
J Rheumatol. 2012 Mar;39(3):662-3. doi: 10.3899/jrheum.111141.
3
Intravascular lymphoma mimicking vasculitis.模仿血管炎的血管内淋巴瘤。
J Clin Neurosci. 2016 Dec;34:224-225. doi: 10.1016/j.jocn.2016.06.010. Epub 2016 Jul 26.
4
Diagnosing CNS vasculitis: the case against empiric treatment.诊断中枢神经系统血管炎：反对经验性治疗的案例
Neurologist. 2012 Jul;18(4):233-8. doi: 10.1097/NRL.0b013e31825c6d23.
5
Intravascular large cell B lymphoma presenting as central nervous system pseudo-vasculitis: A rare diagnostic challenge.血管内大 B 细胞淋巴瘤表现为中枢神经系统假性血管炎：一种罕见的诊断挑战。
Neuroradiol J. 2024 Oct;37(5):651-655. doi: 10.1177/19714009231212351. Epub 2023 Nov 7.
6
A 65-year-old man with headaches and left homonymous hemianopsia.一名65岁男性，有头痛及左侧同向性偏盲症状。
Neuropathology. 2004 Dec;24(4):350-3. doi: 10.1111/j.1440-1789.2004.00588.x.
7
Intravascular large B-cell lymphoma confirmed by brain biopsy: a case report.经脑活检确诊的血管内大B细胞淋巴瘤：一例报告
BMJ Case Rep. 2013 Feb 18;2013:bcr2012007990. doi: 10.1136/bcr-2012-007990.
8
Diagnosis and classification of central nervous system vasculitis.中枢神经系统血管炎的诊断与分类。
J Autoimmun. 2014 Feb-Mar;48-49:149-52. doi: 10.1016/j.jaut.2014.01.007. Epub 2014 Feb 1.
9
[A case of lymphomatosis cerebri rapidly confirmed by brain biopsy].[一例经脑活检迅速确诊的脑淋巴瘤病]
Rinsho Shinkeigaku. 2019 May 28;59(5):286-289. doi: 10.5692/clinicalneurol.cn-001269. Epub 2019 Apr 26.
10
Tumor-Like Presentation of Primary Angiitis of the Central Nervous System.中枢神经系统原发性血管炎的肿瘤样表现
Stroke. 2016 Sep;47(9):2401-4. doi: 10.1161/STROKEAHA.116.013917. Epub 2016 Jul 28.
引用本文的文献
1
Unveiling the Clinical and Imaging Signatures of Intravascular Lymphoma of the Central Nervous System: A Multicentric Cohort Study.揭示中枢神经系统血管内淋巴瘤的临床和影像学特征：一项多中心队列研究
Ann Neurol. 2025 Mar;97(3):435-448. doi: 10.1002/ana.27132. Epub 2024 Nov 28.
2
Rare intravascular large B-cell lymphoma (IVLBCL) can cause atypical intracerebral haemorrhage and mislead diagnostics.罕见的血管内大 B 细胞淋巴瘤（IVLBCL）可引起非典型性颅内出血，从而导致误诊。
BMJ Case Rep. 2024 Sep 20;17(9):e260498. doi: 10.1136/bcr-2024-260498.
3
Case Report: Intravascular Large B-Cell Lymphoma: A Clinicopathologic Study of Four Cases With Review of Additional 331 Cases in the Literature.病例报告：血管内大B细胞淋巴瘤：4例临床病理研究并复习文献中另外331例病例
Front Oncol. 2022 May 13;12:883141. doi: 10.3389/fonc.2022.883141. eCollection 2022.
本文引用的文献
1
Incisional random skin biopsy, not punch biopsy, is an appropriate method for diagnosis of intravascular large B-cell lymphoma: a clinicopathological study of 25 patients.切开式随机皮肤活检而非打孔活检是诊断血管内大B细胞淋巴瘤的合适方法：25例患者的临床病理研究
Br J Dermatol. 2019 Jul;181(1):200-201. doi: 10.1111/bjd.17603. Epub 2019 Mar 7.
2
Random Skin Biopsies Before Brain Biopsy for Intravascular Large B-Cell Lymphoma.血管内大B细胞淋巴瘤患者在进行脑活检前的随机皮肤活检
World Neurosurg. 2019 Jan;121:e364-e369. doi: 10.1016/j.wneu.2018.09.110. Epub 2018 Sep 25.
3
CNS Vasculitis: an Approach to Differential Diagnosis and Management.中枢神经系统血管炎：鉴别诊断与治疗方法。
Curr Rheumatol Rep. 2018 May 30;20(7):37. doi: 10.1007/s11926-018-0747-z.
4
Primary Angiitis of the Central Nervous System.中枢神经系统原发性血管炎
Rheum Dis Clin North Am. 2017 Nov;43(4):503-518. doi: 10.1016/j.rdc.2017.06.001.
5
Intravascular lymphoma mimicking vasculitis.模仿血管炎的血管内淋巴瘤。
J Clin Neurosci. 2016 Dec;34:224-225. doi: 10.1016/j.jocn.2016.06.010. Epub 2016 Jul 26.
6
Primary angiitis of the central nervous system: diagnostic criteria.中枢神经系统原发性血管炎：诊断标准
Neurol Clin. 2015 May;33(2):515-26. doi: 10.1016/j.ncl.2014.12.004. Epub 2015 Feb 2.
7
The natural history of intravascular lymphomatosis.血管内淋巴瘤的自然病史。
Cancer Med. 2014 Aug;3(4):1010-24. doi: 10.1002/cam4.269. Epub 2014 Jun 14.
8
Primary central nervous system vasculitis: analysis of 101 patients.原发性中枢神经系统血管炎：101例患者分析
Ann Neurol. 2007 Nov;62(5):442-51. doi: 10.1002/ana.21226.
9
Intravascular lymphoma: the oncologist's "great imitator".血管内淋巴瘤：肿瘤学家的“模仿大师”。
Oncologist. 2006 May;11(5):496-502. doi: 10.1634/theoncologist.11-5-496.
10
Intravascular lymphoma: clinical presentation, natural history, management and prognostic factors in a series of 38 cases, with special emphasis on the 'cutaneous variant'.血管内淋巴瘤：38例患者的临床表现、自然病程、治疗及预后因素，特别关注“皮肤型”
Br J Haematol. 2004 Oct;127(2):173-83. doi: 10.1111/j.1365-2141.2004.05177.x.
Zotero 插件