Liang Sai, Lim Jia Xu, Lee Hwei Yee, Low Sharon Yy
Neurosurgery, National Neuroscience Institute, Singapore, SGP.
Pathology, Tan Tock Seng Hospital, Singapore, SGP.
Cureus. 2020 Dec 14;12(12):e12068. doi: 10.7759/cureus.12068.
A previously well female presented with a history of progressive functional decline. She had a known history of generalized seropositive myasthenia gravis on long-term mycophenolate mofetil and pyridostigmine. MRI of her brain reported multiple cerebral abscesses based on radiological features. The patient was commenced on intravenous antibiotics, but there was no clinical or radiological response to treatment. Decision was made for a stereotactic biopsy. Intraoperative tissue cultures were negative for infection. However, histology reported B-cell lymphoma with morphological features changes typically seen in corticosteroid-treated lymphoma - an unexpected finding as no steroids were administered as part of her treatment. Owing to the unusual diagnosis, the case is presented in corroboration with current literature.
一名既往健康的女性出现进行性功能衰退病史。她有已知的全身性血清阳性重症肌无力病史，长期服用霉酚酸酯和吡啶斯的明。脑部MRI根据影像学特征报告有多个脑脓肿。患者开始接受静脉抗生素治疗，但治疗后无临床或影像学反应。决定进行立体定向活检。术中组织培养未发现感染。然而，组织学报告为B细胞淋巴瘤，具有皮质类固醇治疗的淋巴瘤中常见的形态学特征变化——这是一个意外发现，因为她的治疗中未使用类固醇。由于诊断不寻常，现结合当前文献介绍该病例。
