Primary CNS Lymphoma vs. Tumefactive Multiple Sclerosis: A Diagnostic Challenge
| Autor: | Mubbasher Sattar, Sameen Bin Naeem, Atif Baig, Hina Sadiq, Farheen Niazi |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Adult
Male Pathology medicine.medical_specialty Multiple Sclerosis Biopsy Lesion Central Nervous System Neoplasms Diagnosis Differential 03 medical and health sciences 0302 clinical medicine Tumefactive multiple sclerosis hemic and lymphatic diseases medicine Humans 030212 general & internal medicine medicine.diagnostic_test Radiotherapy business.industry Brain Neoplasms Brain biopsy Multiple sclerosis General Medicine medicine.disease Magnetic Resonance Imaging Lymphoma Treatment Outcome Lymphoma Large B-Cell Diffuse medicine.symptom Differential diagnosis business Diffuse large B-cell lymphoma 030217 neurology & neurosurgery |
| Zdroj: | Journal of the College of Physicians and Surgeons--Pakistan : JCPSP. 28(1) |
| ISSN: | 1681-7168 |
| Popis: | Primary CNS (central nervous system) lymphoma is a rare condition with the incidence of less than 1% of all non-Hodgkin lymphomas (NHLs) and approximately 2% of all primary brain tumours. Diagnosis can be challenging and necessitates brain biopsy for definitive diagnosis. A 41-year male presented with history of impaired cognition, facial asymmetry, visual impairment and left sided body weakness. MRI brain demonstrated multiple enhancing lesions with one larger lesion in right basal ganglia with surrounding oedema and mass effect. These findings suggested the differential diagnoses of tumefactive multiple sclerosis (MS), primary CNS lymphoma (PCNSL) and tuberculosis. The patient had normal CT chest, abdomen and pelvis, normal CSF examination and cytology, negative CSF oligoclonal bands (OCBs) and negative HIV screening. It was impossible to differentiate between tumefactive MS and PCNSL without undertaking brain biopsy. Diffuse large B cell lymphoma (DLBCL) was the final diagnosis. Diagnosing PCNSL can be challenging and brain biopsy should not be delayed for definitive diagnosis and targeted treatment. |
| Databáze: | OpenAIRE |
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