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• Vol.57 No.9
• CLINICA NEUROL, 57: 504−508, 2017
• Vol.57 No.9 contents

Case Report

Low signal intensity lesions on brain susceptibility-weighted MRI in a patient with intravascular large B-cell lymphoma

Yo Tsuda, M.D.¹⁾, Takuya Oguri, M.D., Ph.D.¹⁾, Keita Sakurai, M.D., Ph.D.²⁾, Tomohiro Kajiguchi, M.D., Ph.D.³⁾, Hideki Kato, M.D., Ph.D.¹⁾ and Hiroyuki Yuasa, M.D., Ph.D.¹⁾

¹⁾Department of Neurology, Tosei General Hospital
²⁾Department of Diagnostic Radiology, Tokyo Metropolitan Geriatric Hospital
³⁾Department of Hematology and Oncology, Tosei General Hospital

A 71-year-old man was admitted to our hospital because of abnormal behavior and generalized convulsion. Brain MRI revealed no abnormalities upon admission. Levels of serum lactate dehydrogenase and soluble interleukin-2 receptors were significantly elevated, whereas the initial bone marrow puncture and random skin biopsy findings were nonmalignant. On the tenth day of admission, brain MRI revealed dot and strip-shaped low signal intensity lesions on susceptibility-weighted images (SWI) disseminated mainly within the cerebral cortex. Administration of high dose methyl-prednisolone improved neither his condition nor these MRI findings. Ground-glass opacities within the bilateral lungs later emerged on the chest CT. The results of a transbronchial lung biopsy and second bone marrow puncture were consistent with a diagnosis of intravascular large B-cell lymphoma (IVLBCL). Despite the lack of histopathological confirmation, the low signal intensities on brain SWI in this case were also considered IVLBCL lesions, reflective of micro-hemorrhagic changes.
Full Text of this Article in Japanese PDF (747K)

(CLINICA NEUROL, 57: 504−508, 2017)
key words: intravascular large B-cell lymphoma (IVLBCL), hemorrhagic change, magnetic resonance imaging (MRI), susceptibility-weighted imaging (SWI)

(Received: 1-Mar-17)