Unilateral Hemispheric Hyperperfusion in Intravascular Large B-cell Lymphoma
Daichi Imamura1, Satoru Fujiwara1, Hiroki Amagase2
1Department of Neurology, Kobe City Medical Center General Hospital, Kobe, JPN.
Cureus
|July 30, 2024
Summary
Intravascular large B-cell lymphoma (IVLBCL) can present with seizures. Arterial spin labeling MRI may reveal unilateral hemispheric hyperperfusion, aiding early diagnosis in challenging cases.
Area of Science:
- Neurology
- Oncology
- Radiology
Background:
- Intravascular large B-cell lymphoma (IVLBCL) diagnosis is challenging due to non-specific symptoms.
- Seizures are an uncommon initial presentation for IVLBCL.
Observation:
- A 68-year-old male presented with altered consciousness and focal seizures.
- Standard MRI sequences (DWI, T2, SWI) were unremarkable.
- Arterial spin labeling (ASL) MRI showed unilateral hemispheric hyperperfusion.
Findings:
- Elevated serum lactate dehydrogenase (LDH) and soluble interleukin-2 receptor (sIL-2R) supported the diagnosis.
- IVLBCL was confirmed via skin biopsy and bone marrow examination.
- The patient experienced tumor lysis syndrome and succumbed to organ failure despite chemotherapy.
Implications:
- This case highlights the importance of considering IVLBCL in adults with refractory seizures.
- ASL MRI may serve as a valuable tool for early IVLBCL detection.
- Prompt diagnosis and treatment are crucial for improving outcomes in IVLBCL.
Keywords:
arterial spin labeling (asl)epilepsyhyperperfusionintravascular large b-cell lymphomaintravascular lymphomaMore Related Videos
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