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Reversible posterior leukoencephalopathy after combination chemotherapy
J Honkaniemi1, V Kähärä, P Dastidar
1Department of Neurology and Rehabilitation, University of Tampere, 33521 Tampere, Finland. bljaho@uta.fi
Neuroradiology
|February 24, 2001
Summary
A young woman with Burkitt's lymphoma developed reversible posterior leukoencephalopathy syndrome (RPLS) after chemotherapy. Early diffusion-weighted MRI predicted irreversible lesions, but high-dose steroids led to full recovery.
Area of Science:
- Neuro-oncology
- Radiology
- Neurology
Background:
- Burkitt's lymphoma is an aggressive non-Hodgkin lymphoma.
- Chemotherapy regimens, including adriamycin, cyclophosphamide, and cytarabine, are used for treatment.
- Reversible posterior leukoencephalopathy syndrome (RPLS) is a rare neurological complication.
Observation:
- A patient with Burkitt's lymphoma developed RPLS during treatment.
- Typical magnetic resonance imaging (MRI) findings consistent with RPLS were observed.
- Diffusion-weighted MRI initially suggested a small, irreversible frontal lobe lesion.
Findings:
- The frontal lobe lesion predicted by early diffusion-weighted MRI was confirmed on later T2-weighted images.
- The patient experienced a full clinical recovery following high-dose steroid administration.
- RPLS symptoms and MRI findings were reversible in this case.
Implications:
- This case highlights the importance of recognizing RPLS in patients undergoing specific chemotherapy.
- Early diffusion-weighted MRI may help predict the extent of irreversible damage in RPLS.
- High-dose steroid therapy can be effective in managing RPLS and promoting recovery.