A 76-year-old man with cognitive and neurological symptoms.
A 76-year-old man presented with cognitive symptoms, followed by headache and weakness of the lower limbs and left arm. The clinical course was progressive but fluctuating. On magnetic resonance imaging (MRI), a contrast-enhancing lesion 1 cm in diameter was seen in the left temporal lobe. This lesion became attenuated and a new contrast-enhancing lesion 1 x 2 cm was seen in the left frontal lobe on a subsequent MRI. Following additional tests, treatment with corticosteroids for presumptive neurosarcoidosis was started, however, he soon expired. At autopsy, there was a tumor-like mass in the left frontal lobe. Pathologic evaluation revealed a primary T-cell lymphoma of the central nervous system (CNS). CNS T-cell lymphomas may be difficult to diagnose, even histologically, due to their frequent small cell morphology and lack of significant atypia.
Brunnström
Hans
H
Dictor
Michael
M
Nilsson
Christer
C
Gülich
Dag
D
Englund
Elisabet
E
D000368:Aged; D001037:Aphasia / Q000209:etiology; D001932:Brain Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D017809:Fatal Outcome; D005625:Frontal Lobe / Q000473:pathology*; D006801:Humans; D007150:Immunohistochemistry; D016399:Lymphoma, T-Cell / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008569:Memory Disorders / Q000209:etiology; D013194:Staining and Labeling