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Case No. 616
2022-02-01~2022-02-28
출제자 : 조세진
Hit : 643
| Period | 2022-02-01~2022-02-28 |
|---|---|
| Diagnosis | Primary central nervous system lymphoma |
| Gender |
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| Age | 69 |
| Clinical information | Question> M/69Y Symptom: Right side weakness, dysarthria 두달 간격으로 찍은 두번의 MRI 검사이다. 그 사이에는 스테로이드 치료를 하였다. 각각의 MRI 검사 후 biopsy를 시행했는데, 예상되는 두번의 진단은? (각각 기술) Images> # Epi 1: ep1_axial T2WI, ep1_axial Gd_T1WI, ep1_axial ADC, ep1_axial CBV # Epi 2: ep2_axial T2WI, ep2_axial Gd_T1WI, ep2_axial ADC, ep2_axial CBV |
| Discussion | # Epi 1: C/W demyelinating disease, # Epi2, malignant lymphoma - Primary central nervous system lymphoma (PCNSL) may rarely be preceded by “sentinel demyelination,” a pathologic entity characterized by histologically confirmed demyelinating inflammatory brain lesions that mimic multiple sclerosis (MS) or acute disseminated encephalomyelitis (ADEM). - Early clinical suspicion for PCNSL and awareness that biopsied lesions may initially show sentinel demyelination suggestive of alternate diagnoses may be essential for early initiation of appropriate therapies and mitigation of disease progression - BMC Neurol. 2016 May 21;16:72. doi: 10.1186/s12883-016-0596-1. |
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