Diffuse Large B-Cell Lymphoma of the Central Nervous System Manifesting with Intratumoral Hemorrhage: A Case Report and Literature Review
| Autor: | Hajime Yonezawa, Hiroyuki Uchida, Ryutaro Makino, Costansia Bureta, Nayuta Higa, Tomoko Takajo, Koji Yoshimoto |
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| Rok vydání: | 2020 |
| Předmět: |
Male
Antimetabolites Antineoplastic medicine.medical_specialty medicine.medical_treatment Fluid-attenuated inversion recovery 03 medical and health sciences 0302 clinical medicine Midline shift medicine Humans Cerebral Hemorrhage Intracerebral hemorrhage medicine.diagnostic_test Brain Neoplasms business.industry Primary central nervous system lymphoma Magnetic resonance imaging Chemoradiotherapy Middle Aged medicine.disease Lymphoma Radiation therapy Methotrexate 030220 oncology & carcinogenesis Surgery Lymphoma Large B-Cell Diffuse Neurology (clinical) Radiology Cranial Irradiation business Diffuse large B-cell lymphoma 030217 neurology & neurosurgery |
| Zdroj: | World Neurosurgery. 143:490-494 |
| ISSN: | 1878-8750 |
| Popis: | Background Cases of primary central nervous system lymphoma manifesting with hemorrhage are very rare, with only a few previous studies available. Case Description A 49-year-old man presented with occipital headache and visual disturbance for the past 4 months. Computed tomography showed a high-density area involving the left basal ganglia, with surrounding vasogenic edema. Head T2∗-weighted imaging showed a hypointense signaling area. Edematous changes and a midline shift were observed on fluid attenuated inversion recovery magnetic resonance imaging. Radiologic features were highly suggestive of intracerebral hemorrhage. Methylprednisolone pulse therapy improved his symptoms transiently and reduced the size of the lesion. Nonetheless, there was recurrence 1 month later. The patient was referred to our institution; a biopsy was performed, and a diffuse large B-cell lymphoma was diagnosed. After 3 cycles of high-dose methotrexate and whole-brain radiation therapy, his symptoms improved, and there were no signs of recurrence. Conclusions We report a very rare case of diffuse large B-cell lymphoma manifested with intratumoral hemorrhage. This case indicates the importance of regular clinical and radiologic follow-up, histopathologic examination, and combined treatment with high-dose methotrexate and whole-brain radiation therapy. |
| Databáze: | OpenAIRE |
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