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Non‐HTLV‐I associated pleomorphic T‐cell lymphoma of the brain mimicking post‐vaccinal acute inflammatory demyelination
Author(s) -
Wanschitz J.,
Hainfellner J.A.,
Simonitsch I.,
Schnizer M.,
Deisenhammer E.,
Terunuma H.,
Iwasaki Y.,
Budka H.
Publication year - 1997
Publication title -
neuropathology and applied neurobiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.538
H-Index - 95
eISSN - 1365-2990
pISSN - 0305-1846
DOI - 10.1111/j.1365-2990.1997.tb01184.x
Subject(s) - medicine , pathology , encephalitis , lymphoma , white matter , autopsy , immunology , magnetic resonance imaging , virus , radiology
Two weeks after vaccination against tick‐borne encephalitis (TBE), a 57‐year‐old female suddenly developed mental confusion and hemiparesis of the left side. Cranial MRI demonstrated extensive bilateral lesions in the fronto‐parietal white matter of both hemispheres, suggesting an acute inflammatory demyelinating disease following vaccination. Despite administration of high‐dose corticosteroids, the patient died 3 weeks after onset of neurological symptoms. Autopsy revealed diffuse infiltrates of a primary cerebral pleomorphic T‐cell lymphoma of medium and large cell type. PCR on brain tissue for HTLV‐I and serology for anti‐HTLV‐I antibodies in CSF and serum were negative; immunocytochemistry on brain tissue did not detect EBV‐related antigen. This is the first recorded observation of a diffusely infiltrating primary central nervous system T‐cell lymphoma, clinically and radiologically mimicking a fatal acute inflammatory demyelinating complication after vaccination.