Revista Biomédica Revisada Por Pares
Para Descargar PDF debe Abrir sesión.
Palabras clave: Dementia, Leukoencephalopathie, Nervous System Neoplasms, Lymphoma, PET-CT Scan
Introduction
Lymphomatosis cerebri is a rare form of primary central nervous system lymphoma characterized by an atypical clinical presentation and neuroimaging, with a poor short-term prognosis.
Case Report
A 51-year-old woman began with clinical manifestations characterized by rapidly progressing cognitive impairment associated with a behavioral disorder, myoclonus, and gait disturbance. The brain magnetic resonance image showed extensive signaling in the bilateral periventricular white matter. The 18F-FDG PET-CT showed severe dorsolateral neocortical hypometabolism in the absence of focal hypermetabolic lesion, a metabolic pattern indicative of cerebri lymphomatosis. A brain biopsy confirmed the diagnosis. The patient started chemotherapy achieving complete remission. Eighteen months after diagnosis, the patient had improved clinically and neuroimaging.
Conclusion
This is the first report in Peru of an entity that should be considered in rapidly progressive dementia and leukoencephalopathy cases. Timely diagnosis and appropriate chemotherapy management can increase patient survival.
Esta obra de Medwave está bajo una licencia Creative Commons Atribución-NoComercial 3.0 Unported. Esta licencia permite el uso, distribución y reproducción del artículo en cualquier medio, siempre y cuando se otorgue el crédito correspondiente al autor del artículo y al medio en que se publica, en este caso, Medwave.
Introduction
Lymphomatosis cerebri is a rare form of primary central nervous system lymphoma characterized by an atypical clinical presentation and neuroimaging, with a poor short-term prognosis.
Case Report
A 51-year-old woman began with clinical manifestations characterized by rapidly progressing cognitive impairment associated with a behavioral disorder, myoclonus, and gait disturbance. The brain magnetic resonance image showed extensive signaling in the bilateral periventricular white matter. The 18F-FDG PET-CT showed severe dorsolateral neocortical hypometabolism in the absence of focal hypermetabolic lesion, a metabolic pattern indicative of cerebri lymphomatosis. A brain biopsy confirmed the diagnosis. The patient started chemotherapy achieving complete remission. Eighteen months after diagnosis, the patient had improved clinically and neuroimaging.
Conclusion
This is the first report in Peru of an entity that should be considered in rapidly progressive dementia and leukoencephalopathy cases. Timely diagnosis and appropriate chemotherapy management can increase patient survival.
Autores:
Miguel A. Vences[1], Adriana F. Saravia-Ayala[1], Elliot Barreto-Acevedo[1]
Citación: Vences MA, Saravia-Ayala AF, Barreto-Acevedo E. Rapidly progressive dementia associated with leukoencephalopathy: A case report of lymphomatosis cerebri. Medwave 2021;21(02):e8138 doi: 10.5867/medwave.2021.02.8138
Fecha de envío: 7/10/2020
Fecha de aceptación: 3/3/2021
Fecha de publicación: 26/3/2021
Origen: No solicitado.
Tipo de revisión: Revisión por pares externa, por cuatro árbitros a doble ciego.
Nos complace que usted tenga interés en comentar uno de nuestros artículos. Su comentario será publicado inmediatamente. No obstante, Medwave se reserva el derecho a eliminarlo posteriormente si la dirección editorial considera que su comentario es: ofensivo en algún sentido, irrelevante, trivial, contiene errores de lenguaje, contiene arengas políticas, obedece a fines comerciales, contiene datos de alguna persona en particular, o sugiere cambios en el manejo de pacientes que no hayan sido publicados previamente en alguna revista con revisión por pares.
Aún no hay comentarios en este artículo.
Para comentar debe iniciar sesión
Medwave publica las vistas HTML y descargas PDF por artículo, junto con otras métricas de redes sociales.
Bakshi R, Mazziotta JC, Mischel PS, Jahan R, Seligson DB, Vinters HV.
Lymphomatosis cerebri presenting as a rapidly progressive dementia: clinical,
neuroimaging and pathologic findings. Dement Geriatr Cogn Disord. 1999 Mar-
Apr;10(2):152-7. | CrossRef | PubMed |Li L, Rong JH, Feng J. Neuroradiological features of lymphomatosis cerebri: A
systematic review of the English literature with a new case report. Oncol Lett.
2018 Aug;16(2):1463-1474. | CrossRef | PubMed |Lee PJ, Berrios I, Ionete C, Smith T. Lymphomatosis cerebri: diagnostic
challenges and review of the literature. BMJ Case Rep. 2016 Nov
24;2016:bcr2016216591. | CrossRef | PubMed |Hatanpaa KJ, Fuda F, Koduru P, Young K, Lega B, Chen W. Lymphomatosis
Cerebri: A Diagnostic Challenge. JAMA Neurol. 2015 Sep;72(9):1066-7. | CrossRef | PubMed |Gagnier JJ, Kienle G, Altman DG, Moher D, Sox H, Riley D; CARE Group*. The
CARE Guidelines: Consensus-based Clinical Case Reporting Guideline Development.
Glob Adv Health Med. 2013 Sep;2(5):38-43. | CrossRef | PubMed |Bühring U, Herrlinger U, Krings T, Thiex R, Weller M, Küker W. MRI features
of primary central nervous system lymphomas at presentation. Neurology. 2001 Aug
14;57(3):393-6. | CrossRef | PubMed |Küker W, Nägele T, Korfel A, Heckl S, Thiel E, Bamberg M, et al. Primary central nervous system lymphomas (PCNSL): MRI features at
presentation in 100 patients. J Neurooncol. 2005 Apr;72(2):169-77. | CrossRef | PubMed |Fisher D, Mantell BS, Urich H. The clinical diagnosis and treatment of
microgliomatosis: report of a case. J Neurol Neurosurg Psychiatry. 1969
Oct;32(5):474-8. | CrossRef | PubMed |Izquierdo C, Velasco R, Vidal N, Sánchez JJ, Argyriou AA, Besora S, et al. Lymphomatosis cerebri: a rare form of primary central nervous system
lymphoma. Analysis of 7 cases and systematic review of the literature. Neuro
Oncol. 2016 May;18(5):707-15. | CrossRef | PubMed |Kerbauy MN, Pasqualin DDC, Smid J, Iquizli R, Kerbauy LN, Nitrini R, et al. Diffuse large B-cell lymphoma of the central nervous
system presenting as "lymphomatosis cerebri" and dementia in elderly man: Case
report and review of the literature. Medicine (Baltimore). 2019
Feb;98(6):e14367. | CrossRef | PubMed |Jiménez PP, Jiménez LO, García FP. Cerebral intravascular lymphomatosis as cause of subacute dementia: Report of a case. Rev. chil. neuro-psiquiatr. [Internet]. 2013;51(1):32-37. | CrossRef |Santos PSF, Vinholi A, da Silva TR, Koike M, Sato HK. Linfomatose Cerebral: Um Raro Diagnóstico para Demência Rapidamente Progressiva. Relato de caso e Revisão de Literatura. jbnc. 31º de março de 2018;26(4):315 -319. [Internet] | Link |Yu H, Gao B, Liu J, Yu YC, Shiroishi MS, Huang MM, et al. Lymphomatosis cerebri: a rare variant of primary central nervous system lymphoma
and MR imaging features. Cancer Imaging. 2017 Oct 5;17(1):26. | CrossRef | PubMed |Jiménez de la Peña MD, Vicente LG, Alonso RC, Cabero SF, Suárez AM, de Vega
VM. The Multiple Faces of Nervous System Lymphoma. Atypical Magnetic Resonance
Imaging Features and Contribution of the Advanced Imaging. Curr Probl Diagn
Radiol. 2017 Mar-Apr;46(2):136-145. | CrossRef | PubMed |Jain TK, Sharma P, Suman SK, Faizi NA, Bal C, Kumar R. Primary central
nervous system lymphoma with lymphomatosis cerebri in an immunocompetent child:
MRI and 18F-FDG PET-CT findings. Rev Esp Med Nucl Imagen Mol. 2013 Nov-
Dec;32(6):394-6. | CrossRef | PubMed |Kawai N, Okubo S, Miyake K, Maeda Y, Yamamoto Y, Nishiyama Y, et al. Use
of PET in the diagnosis of primary CNS lymphoma in patients with atypical MR
findings. Ann Nucl Med. 2010 Jun;24(5):335-43. | CrossRef | PubMed |Gomez-Figueroa E, Peiro-Osuna RP, Reyes-Moreno I, Hernandez-Hernandez A,
Gutierrez-Aceves A, Santos-Zambrano J, et al. Linfoma primario del sistema nervioso
central: experiencia clinica en un centro neurologico [Primary central nervous
system lymphoma: clinical experience in a neurological center]. Rev Neurol. 2019
Jan 16;68(2):59-65. | PubMed |
Estudios originales