Central Nervous System Lymphoma Initially Diagnosed as Tumefactive Multiple Sclerosis after Brain Biopsy
Central Nervous System Lymphoma Initially Diagnosed as Tumefactive Multiple Sclerosis after Brain Biopsy
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DOI：
10.2169/internalmedicine.52.8531
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发表时间：
2013-01-01
影响因子：
1.2
通讯作者：
Tanahashi, Norio
中科院分区：
文献类型：
--
作者：
Ohe, Yasuko;Hayashi, Takeshi;Tanahashi, Norio
一名72岁男性因左同义性偏盲和偏瘫入院。磁共振成像显示右顶叶病变不均匀增强。脑活检显示急性脱髓鞘无恶性肿瘤，导致诊断为肿瘤性多发性硬化症（MS）。患者接受皮质类固醇治疗，临床和放射学均有改善。6个月后，出现了新的病变，第二次活检显示增生异常淋巴细胞。这导致了原发性中枢神经系统淋巴瘤（PCNSL）的修订诊断。由于PCNSL在临床和放射学上都与MS相似，因此PCNSL很难诊断。因此，当强烈怀疑PCNSL时，可能需要进行反复的脑活检。
A 72-year-old man was admitted with left homonymous hemianopsia and hemiparesis. Magnetic resonance imaging revealed a heterogeneously enhanced lesion in the right parietal lobe. A brain biopsy showed acute demyelination without malignancy, which led to a diagnosis of tumefactive multiple sclerosis (MS). The patient received corticosteroid therapy and experienced clinical and radiological improvement. Six months later, new lesions appeared, and a second biopsy revealed proliferation of dysplastic lymphocytes. This led to a revised diagnosis of primary central nervous system lymphoma (PCNSL). Because PCNSL mimics MS both clinically and radiologically, PCNSL is difficult to diagnose. Performing repeated brain biopsies may therefore be required when PCNSL is strongly suspected.