Granulomatous angiitis masquerading as a mass lesion. Magnetic resonance imaging and stereotactic biopsy findings in a patient with occult Hodgkin's disease.
Granulomatous angiitis is a frequently fatal central nervous system vasculitis of unknown pathogenesis sporadically associated with Hodgkin's disease, mixed cellularity type. We describe a 58-year-old woman presenting with headaches, progressive spastic paraparesis, equivocal computed tomography findings, and magnetic resonance imaging findings of increased signal intensity biparietally on T2-weighted imaging in a relatively discrete pattern. Magnetic resonance imaging-directed serial stereotactic biopsies revealed granulomatous angiitis throughout the right parieto-occipital region and splenium. Simultaneous biopsy of an enlarged submandibular mass revealed Hodgkin's disease, lymphocyte-predominant type. This case shows that granulomatous angiitis may be associated with magnetic resonance imaging findings suggesting a mass lesion in lymphocyte-predominant as well as mixed cellularity Hodgkin's disease.
Johnson
M
M
Department of Pathology, Vanderbilt University School of Medicine, Nashville, Tennessee 37232.
Maciunas
R
R
Dutt
P
P
Clinton
M E
ME
Collins
R
R
D001921:Brain / Q000473:pathology*; D003937:Diagnosis, Differential; D005260:Female; D006099:Granuloma / Q000209:etiology / Q000473:pathology*; D006689:Hodgkin Disease / Q000150:complications / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009460:Neurologic Examination; D011184:Postoperative Period; D013238:Stereotaxic Techniques; D014657:Vasculitis / Q000209:etiology / Q000473:pathology*