Neuro-Behcet's disease mimicking multiple brain tumors: diffusion-weighted MR study and literature review.
A 47-year-old man with Behcet's disease presented with a five day history of right side weakness and dysarthria. Ten years ago, he was diagnosed as Behcet's disease. Since then, he was treated with low dose steroids. T1-weighted magnetic resonance images with gadolinium injection revealed ring enhancing lesions with internal hypointensities at the left side of the pons and at the left parietal cortex suggesting multiple metastatic tumors. Diffusion-weighted image and ADC map revealed central hyperintensity on diffusion with low ADC values at both lesions. The histopathology of stereotactic biopsy specimen showed frequent perivascular lymphocytic cuffings, focal necrotic lesions and reactive gliosis. The most common neuropathologic findings in neuro-Behcet's disease are focal necrotic lesions, but the location in cerebral cortex has not been reported before. Long term steroid therapy and antibiotics were administered and the patient recovered gradually. Neuro-Behcet's disease could be presented as brain tumor like lesion, and stereotactic biopsy should be considered in such situation.
Heo
Jae-Hyeok
JH
Department of Neurology, Seoul National University Hospital, 28 Yeongeon-dong, Jongno-gu, Seoul, 110-744, South Korea.
Lee
Soon-Tae
ST
Chu
Kon
K
Kim
Manho
M
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001528:Behcet Syndrome / Q000175:diagnosis* / Q000503:physiopathology; D001921:Brain / Q000473:pathology* / Q000503:physiopathology; D001932:Brain Neoplasms / Q000175:diagnosis* / Q000503:physiopathology; D003937:Diagnosis, Differential; D003951:Diagnostic Errors / Q000517:prevention & control; D038524:Diffusion Magnetic Resonance Imaging; D005911:Gliosis / Q000209:etiology / Q000473:pathology; D006801:Humans; D008214:Lymphocytes / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009336:Necrosis / Q000209:etiology / Q000473:pathology; D010296:Parietal Lobe / Q000473:pathology; D011149:Pons / Q000473:pathology; D013256:Steroids / Q000627:therapeutic use; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D013256:Steroids