Rinsho Shinkeigaku (Clinical Neurology)

Brief Clinical Note

A case report of primary central nervous system lymphoma preceded by cerebral and cerebellar lesion diminishing spontaneously: Consideration of two brain biopsy at the onset and after two years

Makiko Suzuki, M.D.1), Tsuyoshi Uchiyama, M.D.1), Hitoshi Takahashi, M.D.2), Michiko Ito, M.D.1), Takako Shimizu, M.D.1), Hiroshi Kobayashi, M.D.3) and Toshihiko Ohashi, M.D.1)

1)Department of Neurology, Seirei Hamamatsu General Hospital
2)Niigata Brain Research Institute Public Relations & Information Committee
3)Department of Pathology, Seirei Hamamatsu General Hospital

A 57-year-old man suffered a generalized seizure. Brain MRI showed a Gadolinium (Gd) enhanced lesion with massive edema in the left frontal lobe. He received in a brain biopsy a diagnosis of ganglioglioma, probable. After two weeks from the biopsy, brain MRI showed spontaneous remmision of the lesion. Eighteen months after his seizure, a follow-up brain MRI showed a new lesion in the left cerebellar peduncle. However, the lesion also improved spontaneously. After 2 years from the onset, a follow-up examination showed a new lesion in the corpus callosum. At that time even though high dose corticosteroid was given with the diagnosis of multiple sclerosis, the lesion enlarged progressively and uveitis occurred at the same time. He received in the second biopsy a diagnosis of diffuse large B cell lymphoma. We report a case of primary central nervous system lymphoma preceded by cerebral and cerebellar lesion diminishing spontaneously, with consideration of two brain biopsy at the onset and after two years.
Full Text of this Article in Japanese PDF (1099K)

(CLINICA NEUROL, 49: 586|589, 2009)
key words: primary central nervous system lymphoma, Sentinel lesion, multiple sclerosis

(Received: 20-Aug-08)