Open AccessA PROGRESSIVE MULTIFOCAL NEUROLOGICAL SYNDROME IN A 42‐YEAR‐OLD WOMAN
Author(s) -
Cryan Jane,
Brett Francesca M.
Publication year - 2011
Publication title -
brain pathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.986
H-Index - 132
eISSN - 1750-3639
pISSN - 1015-6305
DOI - 10.1111/j.1750-3639.2011.00522.x
Subject(s) - medicine , dysarthria , pathology , cerebrospinal fluid , spinal cord , autopsy , ataxia , perivascular space , white matter , intravascular large b cell lymphoma , neuroimaging , gait ataxia , brain biopsy , magnetic resonance imaging , radiology , lymphoma , biopsy , psychiatry
This is the case of a 42-year-old female who presented with transient dizziness. Her symptoms and signs progressed to include dysarthria, ataxia and cognitive decline over 2 years, such that she was unable to care for herself. She died 4 years after first presentation without a diagnosis. Investigations revealed a normochromic normocytic anaemia. Cerebrospinal fluid was normal. Serial computed tomography brain showed a wedge-shaped frontal infarct but no progressive changes. Examination at autopsy showed discoloration of the gray and white matter of the brain and spinal cord.Microscopy of leptomeningeal and parenchymal vessels showed they were filled with atypical B lymphocytes confined to the intravascular space with multiple infarcts in the brain, cerebellum and spinal cord. A diagnosis of intravascular B cell lymphoma was made and is discussed.