B Cell lymphoma of the brain stem masquerading as myasthenia
| Autor: | G T Plant, P N Shams, Adam D. Waldman |
|---|---|
| Rok vydání: | 2002 |
| Předmět: |
Male
Pathology medicine.medical_specialty Lymphoma B-Cell Biopsy Ocular myasthenia Brain Stem Neoplasm Diagnosis Differential Central neurogenic hyperventilation hemic and lymphatic diseases Myasthenia Gravis medicine Brain Stem Neoplasms Humans Lesson of the Month B-cell lymphoma medicine.diagnostic_test business.industry Middle Aged medicine.disease Myasthenia gravis Lymphoma Psychiatry and Mental health Surgery Neurology (clinical) Differential diagnosis business Brain Stem |
| Zdroj: | Journal of Neurology, Neurosurgery & Psychiatry. 72:271-273 |
| ISSN: | 0022-3050 |
| Popis: | A 54 year old man is described with signs compatible with ocular myasthenia gravis and an apparent excellent response to pyridostigmine. Subsequent clinical progression and further investigation suggested the presence of an inflammatory brain stem lesion, which responded to corticosteroid therapy. Clinical relapse, including the development of central neurogenic hyperventilation, led to a brain stem biopsy, confirming a diagnosis of B cell lymphoma. This case illustrates the propensity of primary CNS lymphoma (PCNSL) to mimic other conditions. Brain MRI is mandatory in presumed "test negative" ocular myasthenia with atypical clinical findings. Spontaneous regression of PCNSL or response to corticosteroids is common and should not mitigate against the diagnosis. Histopathological confirmation should ideally be made before starting therapy, as this may obscure or delay the correct diagnosis. Although PCNSL is rare, it must be considered in all patients with brain stem syndromes, and in all patients 50 years or older with contrast enhancing focal lesions. |
| Databáze: | OpenAIRE |
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