Rinsho Shinkeigaku (Clinical Neurology)

Brief Clinical Note

A case of intravascular large B-cell lymphoma manifested as lacunar infarction

Kazuki Yokota, M.D.1), Maiko Umeda, M.D.1), Shoko Hongo, M.D.1), Takumu Tsuchida, M.D.2), Yukie Umemori, M.D.3) and Nobuya Fujita, M.D., Ph.D.1)

1) Department of Neurology, Nagaoka Red Cross Hospital
2) Department of Hematology, Nagaoka Red Cross Hospital
3) Department of Dermatology, Nagaoka Red Cross Hospital

A 79-year-old man was admitted to our hospital because of sudden onset of left ataxic hemiparesis. Brain MRI diffusion weighted images showed typical lacunar infarction on the right internal capsule. He had no risk factors of cerebrovascular disorder such as hypertension, diabetes mellitus, hyperlipidemia and arrhythmia. On admission, he had a slight fever and his laboratory data showed anemia, thrombocytopenia and elevation of CRP and LDH. Intravascular large B-cell lymphoma (IVLBCL) was suspected because the serum level of soluble IL-2 receptor was also elevated. Pathological diagnosis of IVLBCL was underwent by the skin biopsy from his senile hemangiomas. Although IVLBCL was known to demonstrate various CNS lesions, it is extremely rare to be manifested as a single lacunar infarction, and this case must be important for the differential diagnosis.
Full Text of this Article in Japanese PDF (1420K)

(CLINICA NEUROL, 62: 492−495, 2022)
key words: intravascular large B-cell lymphoma, lacunar infarction, random skin biopsy, senile hemangioma, soluble IL-2 receptor

(Received: 17-Sep-21)