Intravascular lymphomatosis presenting with a conus medullaris syndrome mimicking disseminated encephalomyelitis.
We describe the clinical, radiologic, and postmortem findings of a 42-year-old man with intravascular lymphomatosis. The patient presented with a conus medullaris syndrome followed by progressive, disseminated spinal and cerebral symptoms. Disseminated encephalomyelitis was suspected due to the clinical, radiologic, and cerebrospinal fluid findings and the results of a stereotactic brain biopsy, all of which were compatible with inflammatory CNS disease. Treatment with methylprednisolone and cyclophosphamide led to a temporary remission of symptoms. The patient died 13 months after onset of symptoms. The diagnosis of disseminated intravascular lymphomatosis was established after death.
Schwarz
Stefan
S
Department of Neurology and Neuroradiology, Klinikum Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, Heidelberg 69120, Germany.
Zoubaa
Saida
S
Knauth
Michael
M
Sommer
Clemens
C
Storch-Hagenlocher
Brigitte
B
D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001808:Blood Vessels / Q000473:pathology*; D002543:Cerebral Hemorrhage / Q000209:etiology; D003520:Cyclophosphamide / Q000627:therapeutic use; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D018450:Disease Progression; D004359:Drug Therapy, Combination; D004673:Encephalomyelitis, Acute Disseminated / Q000175:diagnosis*; D017809:Fatal Outcome; D006801:Humans; D008159:Lumbar Vertebrae; D016393:Lymphoma, B-Cell / Q000150:complications / Q000175:diagnosis*; D016403:Lymphoma, Large B-Cell, Diffuse / Q000150:complications / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D013116:Spinal Cord / Q000098:blood supply; D013117:Spinal Cord Compression / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D013904:Thoracic Vertebrae
D000893:Anti-Inflammatory Agents; D003520:Cyclophosphamide; D008775:Methylprednisolone