Yamasaki Masayoshi, Taniguchi Akira, Minami Hirohito, Tada Tomoko, Yabana Tadashi, Naito Yutaka
Department of Neurology, Japanese Red Cross Ise Hospital, Japan.
Department of Hematology, Japanese Red Cross Ise Hospital, Japan.
Intern Med. 2025 May 15;64(10):1574-1580. doi: 10.2169/internalmedicine.3926-24. Epub 2024 Oct 4.
A 54-year-old woman with persistent fatigue and a high fever presented with central pontine myelinolysis (CPM) on brain imaging, despite the absence of neurological symptoms. The patient had a slightly low serum sodium concentration. Further investigation led to a diagnosis of primary splenic diffuse large B-cell lymphoma (PS-DLBCL). Brainstem auditory-evoked potentials (BAEP) indicated minor abnormalities. CPM was successfully resolved after splenectomy and immunochemotherapy. This is the first reported case of CPM in a patient with PS-DLBCL confirmed by a pathological diagnosis following splenectomy and BAEP-detected abnormalities that improved with immunochemotherapy.
一名54岁女性,持续疲劳并伴有高热,脑部影像学检查显示为中央脑桥髓鞘溶解症(CPM),尽管当时并无神经症状。该患者血清钠浓度略低。进一步检查后诊断为原发性脾脏弥漫性大B细胞淋巴瘤(PS-DLBCL)。脑干听觉诱发电位(BAEP)显示有轻微异常。脾切除及免疫化疗后,CPM成功得到缓解。这是首例经脾切除术后病理诊断确诊为PS-DLBCL且经BAEP检测出异常并在免疫化疗后改善的CPM病例报告。