Publication: Progressive multifocal cerebral infarction from intravascular large B cell lymphoma presenting in a man: A case report
Issued Date
2011-01-24
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ISSN
17521947
17521947
17521947
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2-s2.0-78651573474
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Mahidol University
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SCOPUS
Bibliographic Citation
Journal of Medical Case Reports. Vol.5, (2011)
Suggested Citation
Pornpong Jitpratoom, Patcharawan Yuckpan, Panitta Sitthinamsuwan, Wattanachai Chotinaiwattarakul, Yingyong Chinthammitr Progressive multifocal cerebral infarction from intravascular large B cell lymphoma presenting in a man: A case report. Journal of Medical Case Reports. Vol.5, (2011). doi:10.1186/1752-1947-5-24 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/12698
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Title
Progressive multifocal cerebral infarction from intravascular large B cell lymphoma presenting in a man: A case report
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Abstract
Introduction: Intravascular lymphoma is rare, and may present as ischemic stroke. Diagnosis is difficult due to the non-specific presentation and lack of lymphadenopathy, thus leading to frequent instances of autopsy-proven diagnosis. To the best of our knowledge, this is the first report of progressive stroke from intravascular lymphoma diagnosed antemortem by random skin biopsy. Case presentation: A 42-year-old Thai man presented to our hospital with progressive multifocal cerebral infarction. Despite taking aspirin (300 mg/day), his neurological symptoms worsened. During admission, he developed an unexplained fever and hypoxemia. Magnetic resonance angiography clearly showed patency of all cerebral arteries including the internal carotid and vertebrobasilar arteries. Echocardiography, an antiphospholipid antibody test, cerebrospinal fluid cytology and a bone marrow study were normal. Other laboratory test results showed an elevated lactate dehydrogenase level, nephrotic range proteinuria (3.91 g/day), hypoalbuminemia (1.9 g/dL), a very low high-density lipoprotein level (7 mg/dL) and hypertriglyceridemia (353 mg/dL). Because of suspected vasculitis, pulse methylprednisolone was given with transiently minimal improvement. A random skin biopsy from both thighs revealed intravascular large B cell lymphoma. Chemotherapy was not given due to our patient having ventilator associated pneumonia. He died 10 days after the definite diagnosis was established. Conclusion: One etiology of stroke is intravascular lymphoma, in which random skin biopsy can be helpful for antemortem diagnosis. © 2011 Jitpratoom et al; licensee BioMed Central Ltd.