Brain biopsy-proven intravascular lymphomatosis presenting as rapidly recurrent strokes-two case reports.
OBJECTIVE
Intravascular lymphomatosis (IVL) is rare and usually goes undiagnosed until the time of autopsy because of its protean neurological manifestations.


METHODS
In this report, we describe two women who developed rapidly recurrent strokes within one to two months. In both cases, brain magnetic resonance imaging showed progression of bilateral cerebral infarcts, and histopathology from brain biopsy confirmed the diagnosis of IVL. The first case did not receive chemotherapy and died of septic shock one month after diagnosis. The second case received whole brain radiotherapy followed by rituximab-containing chemotherapy, and experienced partial improvement of neurological deficits. However, she began to deteriorate in consciousness at 8 months and became stuporous at 10 months after the onset of symptoms.


CONCLUSIONS
IVL should be considered as a possible etiology if multiple strokes occur in a short period of time.
Division of Neurology, Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi City, Taiwan.
Ling-Chien
LC
Hung
Division of Hematology and Oncology, Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi City, Taiwan.
Jui-Hung
JH
Tsai
Division of Neurology, Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi City, Taiwan.
Chi-Shun
CS
Wu
Department of Pathology, Ditmanson Medical Foundation Chia- Yi Christian Hospital, Chiayi City, Taiwan.
Yuan-Chang
YC
Dai
Department of Pathology, Ditmanson Medical Foundation Chia- Yi Christian Hospital, Chiayi City, Taiwan.
Chien-Chin
CC
Chen
Division of Neurology, Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi City, Taiwan.
Sheng-Feng
SF
Sung
D000368:Aged; D001706:Biopsy; D001921:Brain / Q000473:pathology*; D002544:Cerebral Infarction / Q000209:etiology* / Q000473:pathology; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D016393:Lymphoma, B-Cell / Q000150:complications* / Q000473:pathology; D008279:Magnetic Resonance Imaging; D012008:Recurrence; D020521:Stroke / Q000209:etiology* / Q000473:pathology; D019043:Vascular Neoplasms / Q000150:complications* / Q000473:pathology