title: Primary central nervous system lymphoma masquerading as herpes encephalitis: clinical, magnetic resonance imaging, and pathologic findings.
abstract: An 84-year-old man presented with acute confusion, global aphasia, and fever. Magnetic resonance imaging (MRI) showed hyperintense lesions on T2-weighted and fluid-attenuated inversion recovery (FLAIR) images predominantly affecting the cortical gray matter of the left mesial temporal and inferior frontal lobes, and insula. Acyclovir was prescribed for presumed viral encephalitis. Clinical and MRI worsening prompted a left temporal lobe biopsy that revealed primary central nervous system lymphoma (PCNSL). This case adds to the MRI spectrum of PCNSL and illustrates that it may mimic the clinical and MRI presentation of herpes simplex encephalitis.
authors.affiliation: Department of Neurology, and Kaleida Health, State University of New York at Buffalo School of Medicine and Biomedical Sciences, USA.
authors.forename: Pierre
authors.initials: P
authors.lastname: Giglio
authors.forename: Rohit
authors.initials: R
authors.lastname: Bakshi
authors.forename: Sandra
authors.initials: S
authors.lastname: Block
authors.forename: Peter
authors.initials: P
authors.lastname: Ostrow
authors.forename: Patrick M
authors.initials: PM
authors.lastname: Pullicino
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000473:pathology; D001932:Brain Neoplasms / Q000175:diagnosis* / Q000473:pathology; D020803:Encephalitis, Herpes Simplex / Q000175:diagnosis*; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000175:diagnosis* / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male