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Washington University Experience | NEOPLASMS (HEMATOLYMPHOID) | Lymphomatosis cerebri | 1A0 Case 1 History
Case History (Case 1) ---- The patient was a 58 year old woman with a history of lymphocytic vitritis, migraines, and gait instability leading to a shoulder fracture in March of 2011. The patient underwent vitrectomy and subsequent workup was negative for infection; vitreous fluid cytology showed atypical cytology with a mixed lymphoid component. MRI of the brain showed multiple FLAIR and T2 hyperintensities involving subcortical and periventricular white matter with increased confluence and new subtle contrast enhancement, including subcortical lesions have central hypointensities. Multiple cerebrospinal fluid samples showed increased numbers of lymphocytes but no clonal B-cell population by flow cytometry. Clinical differential diagnosis included an inflammatory demyelinating process, central nervous system lymphoma, vasculitis, granulomatous disease, collagen vascular disease, or CADASIL. Operative procedure: Right frontal craniotomy for open brain biopsy.
