血管壁磁共振成像显示血管内大 B 细胞淋巴瘤浸润：与病理结果的关联

IF 1 4区医学 Q3 MEDICINE, GENERAL & INTERNAL Internal Medicine Pub Date : 2024-11-08 DOI:10.2169/internalmedicine.4559-24

Masaomi Yamamoto, Tomohisa Dembo, Keisuke Sawada, Baku Hashimoto, Satoru Ouji, Kenichi Kaida

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引用次数: 0

摘要

一名 75 岁的男子出现认知能力下降、头痛和共济失调步态。磁共振成像（MRI）显示多个脑区出现急性梗死，血管壁磁共振成像（VW-MRI）显示一些颅内动脉的动脉壁同心增厚和增强，初步提示为原发性中枢神经系统血管炎（PCNSV）。尽管接受了免疫抑制治疗，但患者仍出现了进一步的脑梗塞。皮肤活检发现了血管内大 B 细胞淋巴瘤（IVLBCL），尸检发现动脉壁上的肿瘤细胞与 VW-MRI 发现一致。本病例强调了仅凭影像学检查结果误诊 PCNSV 的风险，并强调了组织学确诊的必要性。

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Vessel Wall Magnetic Resonance Imaging Showing Intravascular Large B-cell Lymphoma Infiltration: Association with Pathological Findings.

A 75-year-old man presented with cognitive decline, headaches, and ataxic gait. Magnetic resonance imaging (MRI) revealed acute infarcts in multiple brain regions, and vessel wall MRI (VW-MRI) demonstrated concentric arterial wall thickening and enhancement in some intracranial arteries, initially suggesting primary central nervous system vasculitis (PCNSV). Despite immunosuppressive therapy, the patient developed further infarction. A skin biopsy revealed intravascular large B-cell lymphoma (IVLBCL), and autopsy revealed tumor cells in the arterial walls corresponding to the VW-MRI findings. This case highlights the risk of a misdiagnosis of PCNSV based solely on imaging findings and underscores the need for histological confirmation.

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来源期刊

Internal Medicine 医学-医学：内科

CiteScore

1.90

自引率

8.30%

发文量

审稿时长

2.2 months

期刊介绍： Internal Medicine is an open-access online only journal published monthly by the Japanese Society of Internal Medicine. Articles must be prepared in accordance with "The Uniform Requirements for Manuscripts Submitted to Biomedical Journals (see Annals of Internal Medicine 108: 258-265, 1988), must be contributed solely to the Internal Medicine, and become the property of the Japanese Society of Internal Medicine. Statements contained therein are the responsibility of the author(s). The Society reserves copyright and renewal on all published material and such material may not be reproduced in any form without the written permission of the Society.