Rinsho Shinkeigaku (Clinical Neurology)

Case Report

A case of central nervous system primary lymphomatoid granulomatosis with multiple vascular lesions in the spinal cord and brain

Takahiro Kawase, M.D.1), Yuko Takeuchi, M.D., Ph.D.1)2), Jun Ochiai, M.D., Ph.D.1) and Tatsunari Satake, M.D., Ph.D.3)

1) Department of Neurology, Ekisaikai Hospital
2) Department of Neurology, Masuko Memorial Hospital
3) Department of Pathology, Ekisaikai Hospital

A 71-year-old man was hospitalized because of low back pain and weakness in both lower limbs. He presented with fever and stiff neck, and his cerebrospinal fluid sample contained blood. MRI revealed intramedullary and epidural hemorrhages in the spinal cord. Microhemorrhages occurred frequently in the central nervous system over a short period. A brain biopsy was performed. The diagnosis was primary lymphomatoid granulomatosis (LYG) of the central nervous system (grade 2). As a result of lymphocytic infiltration to the vascular walls in LYG, hemorrhages occurred in multiple sites in the central nervous system. The biopsy of samples from the sites of microhemorrhages proved useful for diagnosis even in the absence of mass lesions.
Full Text of this Article in Japanese PDF (5358K)

(CLINICA NEUROL, 61: 618−623, 2021)
key words: lymphomatoid granulomatosis, hematomyelia, stroke, primary central nervous system, spinal epidural hematoma

(Received: 5-Feb-21)