医学
细胞淋巴瘤
淋巴瘤
磁共振成像
放射科
活检
不明原因发热
立体定向活检
甲氨蝶呤
化疗
切碎
病理
外科
作者
Karin Boslooper,D Dijkhuizen,Annette W.G. van der Velden,Mehmet Sinan Dal,Jan F. Meilof,Klaas Hoogenberg
出处
期刊:Netherlands Journal of Medicine
[Elsevier]
日期:2010-06-01
卷期号:68 (6): 261-264
被引量:6
摘要
Intravascular large B-cell lymphoma (IVLBCL) is a rare and aggressive variant of diffuse large B-cell lymphoma with frequent involvement of the central nervous system. Its atypical presentation often delays the diagnosis and due to its aggressive behaviour, the diagnosis is made post-mortem in half of the cases. We report a case of a 67-year-old male patient presenting with speech difficulties and balance disturbances in whom a magnetic resonance imaging (MRI) scan showed multiple lesions of the white matter, denoted as embolic infarctions. He was treated for a suspected endocarditis with antibiotics, but deteriorated neurologically with persistent fever. A consecutive FDG -PET /CT revealed an increased uptake in the adrenals, of which a biopsy showed IVLB CL. The patient was successfully treated with systemic R-CHOP with intrathecal methotrexate and achieved complete remission after six cycles of chemotherapy. The potential role of FDG-PET/CT is illustrated by this case leading to an exceptional diagnosis of IVLBCL.
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