Lymphocytic vasculitis mimicking aggressive multifocal cerebral neoplasm: mr imaging and MR spectroscopic appearance.
We present a case of multifocal enhancing lesions confined to the right cerebral hemisphere that mimicked diffuse neoplasm. MR spectroscopy revealed not only minimal elevation of the choline peak, but also marked elevation of the glutamate and glutamine peaks, findings that are more suggestive of an inflammatory process. Biopsy showed lymphocytic vasculitis, a rare variant of primary angiitis of the CNS. Following appropriate medical therapy, MR imaging demonstrated complete resolution of the lesions.
Panchal
Neeraj J
NJ
Department of Radiology, University of California, San Diego Medical Center, San Diego, CA 92103, USA.
Niku
Soheil
S
Imbesi
Steven G
SG
D000328:Adult; D001921:Brain / Q000378:metabolism / Q000473:pathology; D001932:Brain Neoplasms / Q000175:diagnosis*; D002794:Choline / Q000378:metabolism; D003937:Diagnosis, Differential; D005260:Female; D018698:Glutamic Acid / Q000378:metabolism; D005973:Glutamine / Q000378:metabolism; D006801:Humans; D008214:Lymphocytes / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D009682:Magnetic Resonance Spectroscopy; D020293:Vasculitis, Central Nervous System / Q000175:diagnosis* / Q000473:pathology
D005973:Glutamine; D018698:Glutamic Acid; D002794:Choline