1. Intravascular Lymphoma with an Acute Course of Cerebellar Hemorrhage: A Case Report
- Author
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Hadzuki Matsuda, Keisuke Ueki, Takeo Uzuka, Fumi Higuchi, Phyo Kim, and Ryohei Otani
- Subjects
medicine.medical_specialty ,Lymphoma ,Nausea ,intravascular lymphoma ,Central nervous system ,Case Report ,03 medical and health sciences ,0302 clinical medicine ,Cerebellar Diseases ,venous involvement ,Parenchyma ,medicine ,Humans ,Cerebral Hemorrhage ,Cerebellar Vein ,medicine.diagnostic_test ,business.industry ,congestion ,Magnetic resonance imaging ,Middle Aged ,central nervous system ,medicine.disease ,cerebellar hemorrhage ,Hyperintensity ,Diffusion Magnetic Resonance Imaging ,medicine.anatomical_structure ,Positron-Emission Tomography ,030220 oncology & carcinogenesis ,Female ,Surgery ,Neurology (clinical) ,Radiology ,medicine.symptom ,Tomography, X-Ray Computed ,Complication ,business ,030217 neurology & neurosurgery - Abstract
Intravascular lymphoma (IVL) has been characterized in many case reports by multiple white matter lesions reflecting ischemic changes. In contrast, there are very few case reports of cerebral or cerebellar hemorrhage resulting from IVL. A 56-year-old woman was referred to our department with two-week history of headache, nausea, and poor appetite. Gadolinium (Gd)-enhanced magnetic resonance imaging (MRI) showed dilated veins on the cerebellar surface. No ischemic lesions were detected on diffusion-weighted images. Three days after admission, the patient had a large cerebellar hemorrhage, prompting emergency surgery. Unfortunately, the patient died on the 11th postoperative day. Massive CD20-positive lymphoma cells were recognized in the cerebellar veins, but not in the arteries or the parenchyma of the brain. This is the rare case report of a cerebellar hemorrhage complication from IVL that might have been caused by venous congestion. The dilated veins on the cerebellar surface recognized from the Gd-enhanced T1-weighted images were specific clues in this case.
- Published
- 2018