Related Experiment Video
Updated: Apr 18, 2026
12:52
Isolation and Flow Cytometric Analysis of Glioma-infiltrating Peripheral Blood Mononuclear Cells
Published on: November 28, 2015
16.7K
Glioblastoma Mimicking Autoimmune Encephalitis
Connor M Tierney1, Marinos Kontzialis2
1Department of Radiology, Northwestern Medicine, Chicago, IL, USA.
The Neurohospitalist
|May 26, 2025
Summary
Gliomatosis cerebri, a rare brain tumor, can mimic autoimmune encephalitis due to symmetric MRI findings. This case highlights the importance of considering glioblastoma, even with atypical presentations, to ensure accurate diagnosis and treatment.
Area of Science:
- Neuro-oncology
- Neuroradiology
- Neuropathology
Background:
- Autoimmune encephalitis and glioblastoma can present with overlapping symptoms and imaging findings.
- Symmetric brain lesions on MRI can lead to misdiagnosis, particularly in differentiating inflammatory from neoplastic processes.
- Gliomatosis cerebri is a rare form of diffuse glioma that presents challenges in early diagnosis.
Purpose of the Study:
- To report a case of gliomatosis cerebri initially misdiagnosed as autoimmune encephalitis.
- To emphasize the importance of considering neoplastic processes in cases with symmetric brain lesions on MRI.
- To highlight the diagnostic challenges and the role of brain biopsy in confirming the diagnosis.
Main Methods:
- A 66-year-old female patient with progressive memory loss and gait imbalance.
- Initial MRI showing symmetric T2 FLAIR hyperintensities in mesial temporal lobes, thalami, and cingulate gyri, favoring autoimmune encephalitis.
- Treatment with immunosuppression (plasmapheresis, steroids) followed by repeat MRI and eventual brain biopsy confirming IDH wild-type glioblastoma (gliomatosis cerebri).
Main Results:
- The patient's initial presentation and MRI findings were suggestive of autoimmune encephalitis, leading to immunosuppressive therapy.
- Despite treatment, neurological function declined, prompting further investigation.
- Brain biopsy revealed IDH wild-type glioblastoma, specifically gliomatosis cerebri, with diffuse and multifocal involvement across cerebral lobes.
Conclusions:
- Symmetric and multifocal brain lesions on MRI can be a challenging diagnostic feature, potentially mimicking inflammatory conditions like autoimmune encephalitis.
- Gliomatosis cerebri should be considered in the differential diagnosis of such presentations, even when autoimmune etiologies are strongly suspected.
- Brain biopsy remains a critical tool for definitive diagnosis in ambiguous cases, guiding appropriate oncological management.
Keywords:
autoimmune encephalitisclinical specialtyepilepsyglioblastomagliomatosis cerebrineuroradiologyseizuresMore Related Videos
Related Concept Videos
01:19Encephalitis l: Introduction
3
Encephalitis is inflammation of the brain parenchyma, most often due to infections or autoimmune processes. It presents with neuropsychiatric features such as fever, altered mental status, behavioral changes, cognitive dysfunction, seizures, focal deficits, and sometimes autonomic instability. In some cases, the meninges are also involved, resulting in meningoencephalitis.Infectious CausesInfectious encephalitis is most commonly viral but can also result from bacterial, fungal, or parasitic...
3
01:26Encephalitis ll: Pathophysiology
3
Encephalitis is inflammation of the brain parenchyma caused by direct viral invasion or immune-mediated mechanisms triggered by infections or tumors. Both processes lead to neuronal injury, disrupted neurotransmission, and diverse neurological symptoms, often with overlapping clinical and pathological features.Autoimmune EncephalitisIn autoimmune encephalitis, antibodies target neuronal antigens on cell surfaces, synapses, or within neurons. A key example is anti-NMDAR encephalitis, which can...
3
01:25Arboviral Encephalitis
46
Arboviral encephalitis refers to brain inflammation caused by arthropod-borne viruses, particularly those transmitted through mosquito vectors. Among these, West Nile virus (WNV), a member of the Flaviviridae family, is a significant public health concern. WNV is an enveloped, positive-sense, single-stranded RNA virus. Human infection typically begins when an infected mosquito introduces the virus into the dermis during feeding. The primary transmission cycle involves birds as amplifying hosts...
46