title: Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS) after treatment for Hodgkin's lymphoma.
abstract: Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS) is a rare central nervous system (CNS) disorder with distinct radiological features. However, CLIPPERS may mimic CNS lymphoma, and several cases in which CLIPPERS occurred premonitory to CNS lymphoma have been reported. We report a 31-year-old man presenting with progressive gait ataxia and the characteristic MRI features of CLIPPERS. He was diagnosed with stage II Hodgkin's lymphoma at the age of 15, and we considered the possibility of newly emerged CNS lymphoma occurring in the immunosuppressive condition after the treatment of Hodgkin's lymphoma. Histological findings showed no evidence of CNS lymphoma and the neurological symptoms were resolved by steroids. Although CLIPPERS developed in the reverse order in this case, CLIPPERS should be considered in different diagnosis for CNS lymphoma.
authors.affiliation: Department of Neurology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan. k-mash.1992@live.jp.
authors.forename: Kyoko
authors.initials: K
authors.lastname: Mashima
authors.affiliation: Department of Neurology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan. sgsuzuki@z3.keio.jp.
authors.forename: Shigeaki
authors.initials: S
authors.lastname: Suzuki
authors.affiliation: Division of Hematology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan. tmori@a3.keio.jp.
authors.forename: Takehiko
authors.initials: T
authors.lastname: Mori
authors.affiliation: Department of Neurology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan. shimizu-toshi@umin.ac.jp.
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Shimizu
authors.affiliation: Department of Neurology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan. ymd.jan.88@image.ocn.ne.jp.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yamada
authors.affiliation: Division of Diagnostic Pathology, Keio University School of Medicine, Tokyo, Japan. shirose1231@gmail.com.
authors.forename: Shigemichi
authors.initials: S
authors.lastname: Hirose
authors.affiliation: Division of Hematology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan. okamoto@a7.keio.jp.
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Okamoto
authors.affiliation: Department of Neurology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan. nrsuzuki@a2.keio.jp.
authors.forename: Norihiro
authors.initials: N
authors.lastname: Suzuki
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use; D001706:Biopsy; D016543:Central Nervous System Neoplasms / Q000188:drug therapy; D002908:Chronic Disease; D003520:Cyclophosphamide / Q000008:administration & dosage; D003937:Diagnosis, Differential; D004660:Encephalitis / Q000175:diagnosis* / Q000188:drug therapy* / Q000473:pathology; D006689:Hodgkin Disease / Q000188:drug therapy; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D059906:Neuroimaging; D011149:Pons / Q000473:pathology*; D011239:Prednisolone / Q000008:administration & dosage*; D011241:Prednisone / Q000008:administration & dosage; D011344:Procarbazine / Q000008:administration & dosage; D016896:Treatment Outcome; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D011344:Procarbazine; D014750:Vincristine; D003520:Cyclophosphamide; D011239:Prednisolone; D011241:Prednisone
keywords: Brain biopsy; CLIPPERS; CNS lymphoma; MRI