Department of Hematology, Kochi Medical School, Kochi University, Japan.
Department of Radiology, Kochi Medical School, Kochi University, Japan.
Intern Med. 2021 May 15;60(10):1597-1600. doi: 10.2169/internalmedicine.6386-20. Epub 2020 Dec 7.
Mild encephalitis/encephalopathy with reversible splenial lesion (MERS) has not been described in lymphoma patients. A 65-year-old man with refractory mantle cell lymphoma (MCL) presented typical MRI features of MERS. The patient's cerebrospinal fluid contained an increased number of reactive T-cells; a small number of MCL cells were detected by immunoglobulin heavy chain-polymerase chain reaction (IGH-PCR). His symptoms and the splenial lesion resolved in response to ibrutinib treatment, although the patient eventually died of progressive MCL with overt leptomeningeal disease. We suggest that central nervous system involvement in MCL can present clinicoradiological features of MERS and that ibrutinib could be a choice of treatment.
轻度脑炎/脑病伴可逆性胼胝体压部病变（MERS）尚未在淋巴瘤患者中描述。一位 65 岁患有难治性套细胞淋巴瘤（MCL）的男性出现了 MERS 的典型 MRI 特征。患者的脑脊液中含有大量反应性 T 细胞；通过免疫球蛋白重链-聚合酶链反应（IGH-PCR）检测到少量 MCL 细胞。他的症状和胼胝体病变在依鲁替尼治疗后得到缓解，尽管患者最终死于伴有明显脑膜疾病的进展性 MCL。我们建议，MCL 中枢神经系统受累可表现为 MERS 的临床影像学特征，依鲁替尼可能是一种治疗选择。
