Multiple Cerebral Hemorrhages With Microbleeds in Intravascular Large B-Cell Lymphoma

Masamune Kimura; Satoru Fujiwara; Atsushi Tanaka; Yoshihiro Omura; Daisuke Yamashita; Takuya Hinoda; Nobuyuki Sakai; Nobuo Kohara

doi:10.1016/j.jstrokecerebrovasdis.2020.104798

Multiple Cerebral Hemorrhages With Microbleeds in Intravascular Large B-Cell Lymphoma

J Stroke Cerebrovasc Dis. 2020 Jun;29(6):104798. doi: 10.1016/j.jstrokecerebrovasdis.2020.104798. Epub 2020 Apr 2.

Authors

Masamune Kimura¹, Satoru Fujiwara², Atsushi Tanaka³, Yoshihiro Omura⁴, Daisuke Yamashita⁵, Takuya Hinoda⁶, Nobuyuki Sakai⁴, Nobuo Kohara¹

Affiliations

¹ Kobe City Medical Center General Hospital, Department of Neurology, Kobe, Hyogo, Japan.
² Kobe City Medical Center General Hospital, Department of Neurology, Kobe, Hyogo, Japan. Electronic address: [email protected].
³ Kobe City Medical Center General Hospital, Department of Hematology, Kobe, Hyogo, Japan.
⁴ Kobe City Medical Center General Hospital, Department of Neurosurgery, Kobe, Hyogo, Japan.
⁵ Kobe City Medical Center General Hospital, Department of Pathology, Kobe, Hyogo, Japan.
⁶ Kobe City Medical Center General Hospital, Department of Radiology, Kobe, Hyogo, Japan.

PMID: 32249205
DOI: 10.1016/j.jstrokecerebrovasdis.2020.104798

Abstract

This is an extremely rare reported case of intravascular large B-cell lymphoma (IVLBCL) presenting with acute hemorrhages and numerous microbleeds. An 80-year-old man presented with consciousness disturbances after convulsion. Computed tomography revealed multiple hemorrhages, and susceptibility-weighted imaging (SWI) demonstrated numerous microbleeds. Brain biopsy showed CD20-positive cells in small vessels; accordingly, IVLBCL was diagnosed. IVLBCL should be considered as a differential diagnosis in multiple cerebral hemorrhages and microbleeds.

Keywords: Intravascular large B-cell lymphoma—multiple hemorrhages—microbleeds—susceptibility-weighted imaging.

Publication types

Case Reports

MeSH terms

Aged, 80 and over
Antigens, CD20 / analysis
Antineoplastic Combined Chemotherapy Protocols / administration & dosage
Biomarkers, Tumor / analysis
Biopsy
Cerebral Hemorrhage / diagnostic imaging
Cerebral Hemorrhage / etiology*
Cerebral Hemorrhage / pathology
Cyclophosphamide / administration & dosage
Diffusion Magnetic Resonance Imaging
Doxorubicin / administration & dosage
Hematoma / diagnostic imaging
Hematoma / etiology*
Hematoma / pathology
Humans
Immunohistochemistry
Lymphoma, B-Cell / complications*
Lymphoma, B-Cell / diagnostic imaging
Lymphoma, B-Cell / drug therapy
Lymphoma, B-Cell / pathology
Male
Prednisone / administration & dosage
Rituximab / administration & dosage
Tomography, X-Ray Computed
Treatment Outcome
Vascular Neoplasms / complications*
Vascular Neoplasms / diagnostic imaging
Vascular Neoplasms / drug therapy
Vascular Neoplasms / pathology
Vincristine / administration & dosage

Substances

Antigens, CD20
Biomarkers, Tumor
R-CHOP protocol
Rituximab
Vincristine
Doxorubicin
Cyclophosphamide
Prednisone