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[A case of plasma cell granuloma associated with cerebral infarction]
Abstract:
A 36-year-old male complained of double-vision and pain of left orbita. On admission, T1-weighted Gd-enhanced MR image of his head showed high intensity lesion in the left carvenous sinus, and his chest X-P showed multiple coin lesions. Microscopic findings of lung open biopsy specimen showed prolifelation of mature plasma cell in the granuloma and the patient was diagnosed as having plasma cell granuloma. Although the lung lesions had a tendency to spontaneous remission, we started the steroid pulse therapy and betamethasone (8 mg/day) therapy for intracranial lesion. Then the lung lesions vanished and we decreased the dose of betamethasone from 8 mg/day to 6 mg/day. As the results, the intracranial lesion of this patient expanded and left middle cerebral artery occluded, resulting in right hemiparesis and total aphasia. This is the first case report of plasma cell granuloma with a lesion in the central nervous system associated with cerebral infarction.
Insights
Plasma cell granuloma, a rare condition, can affect the central nervous system. This case highlights a patient experiencing neurological deficits after treatment for intracranial plasma cell granuloma.
Area of Science:
- Neurology
- Pathology
- Radiology
Background:
- Plasma cell granuloma is a rare benign condition characterized by proliferation of plasma cells.
- It typically affects the lungs but can occur in various organs.
Observation:
- A 36-year-old male presented with double vision and orbital pain, alongside multiple coin lesions on chest X-ray.
- MRI revealed a lesion in the left cavernous sinus.
Findings:
- Microscopic examination confirmed plasma cell granuloma.
- Intracranial lesion progression and left middle cerebral artery occlusion occurred after reducing betamethasone dosage.
- This led to right hemiparesis and total aphasia.
Implications:
- This is the first reported case of plasma cell granuloma involving the central nervous system and associated with cerebral infarction.
- The findings suggest potential risks of intracranial lesion expansion and cerebrovascular events during treatment.