Clinical image - (2018) Volume 9, Issue 2
We reported a 52 years old female patient presented with sleep habit changing, slugishness and progressive legs weakness. Her brain MRI shows lesions in bilateral subcortex, bilateral periventricular region, left pedunculus cerebri, callosum, left thalamus, bilateral basal ganglia region, displaying longT1, long T2 signal, with some lesions enhanced after contrast administration. The pathology obtained from brain biopsy suggested diffuse large B-cell lymphoma.
Keywords: MRI; Lymphoma; Multiple sclerosis
A 52 years old female patient changed her sleep habit- her sleep time increased gradually during the last 3 months. She became sluggish during the last 1 month. 4 days before she was admitted to our department, she developed progressive legs weakness. Her brain MRI shows lesions in bilateral subcortex, bilateral periventricular region, left pedunculus cerebri, callosum, left thalamus, bilateral basal ganglia region, dispalying long T1, long T2 signal, with some lesions enhanced after contrast administration (Figure 1). She was misdiagnosed as multiple sclerosis and given glucocorticoid through intravenous drip [1-5]. She recovered rapidly, but relapsed after 3 weeks. She underwent brain biopsy during the second admition. The pathology suggested diffuse large B-cell lymphoma. Then she was given chemotherapy, but unfortunately, she died half a year later.
Figure 1: (A) Bilateral subcortex lesions displayed high signal on T2 FLAIR. (B) Lesions in bilateral periventricular region displayed high signal on T2 FLAIR. (C) The lesion in the left pedunculus cerebri displayed high signal on T2 FLAIR. (D) The lesion in the left subcortex displayed homogeneous enhancement on T1-weighted contrast-enhanced MRI. (E) The lesion in the left periventricular region displayed ring-enhancement on T1-weighted contrastenhanced MRI. (F) The lesion in the left pedunculus cerebri displayed no enhancement on T1-weighted contrast-enhanced MRI.
