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Periventricular involvement in CNS lymphomatoid granulomatosis: MR demonstration
A S Smith1, T E Huang, M A Weinstein
1Department of Radiology, University Hospital of Cleveland, OH 44106.
Abstract:
We report a case of intracranial lymphomatoid granulomatosis shown by magnetic resonance (MR) as a focal periventricular lesion. The patient had an undulant clinical course manifested by multiple peripheral and cranial neuropathies. Both the clinical course and the MR findings were difficult to differentiate from an unusual presentation of multiple sclerosis. Autopsy correlation was obtained after the patient succumbed to cardiopulmonary arrest during status epilepticus.
Insights
We describe a rare case of intracranial lymphomatoid granulomatosis, initially mimicking multiple sclerosis on MRI. This condition presented with neurological deficits and ultimately led to fatal cardiopulmonary arrest.
Area of Science:
- Neurology
- Oncology
- Pathology
Background:
- Intracranial lymphomatoid granulomatosis is a rare lymphoproliferative disorder.
- Distinguishing it from other neurological conditions can be challenging.
Observation:
- A patient presented with a focal periventricular lesion on magnetic resonance (MR) imaging.
- The clinical course involved fluctuating peripheral and cranial neuropathies.
Findings:
- MR findings and clinical presentation were difficult to differentiate from multiple sclerosis.
- Autopsy confirmed intracranial lymphomatoid granulomatosis.
Implications:
- Highlights the importance of considering rare conditions in neurological diagnoses.
- Emphasizes the need for comprehensive diagnostic approaches when faced with ambiguous presentations.
- Underscores the diagnostic challenges in differentiating lymphomatoid granulomatosis from demyelinating diseases.