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BMJ Case Reports 2009; doi:10.1136/bcr.08.2008.0752
  • Findings that shed new light on the possible pathogenesis of a disease or an adverse effect

Dementia and leukoencephalopathy due to lymphomatosis cerebri

  1. Jan Lewerenz1,
  2. Xiao-Qi Ding2,
  3. J Matschke3,
  4. C Schnabel3,
  5. P Emami3,
  6. D von Borczyskowski3,
  7. R Buchert3,
  8. T Krieger3,
  9. M de Wit3,
  10. A Münchau3
  1. 1
    Salk Institute for Biological Studies, 10100 North Torrey Pines Road, La Jolla, California, CA 92037, USA
  2. 2
    University Medical Center Hannover, Carl-Neuberg-Strasse 1, Hannover, 30625, Germany
  3. 3
    University Medical Centre Hamburg-Eppendorf, Martinistrasse 52, Hamburg, D-20246, Germany
  1. lewerenz{at}salk.edu
  • Published 2 February 2009

Summary

Lymphomatosis cerebri (LC) is a rare variant of primary central nervous system lymphoma (PCNSL). Clinically, the disease typically presents with a rapidly progressive dementia and unsteadiness of gait. Its presentation on cerebral MRI, which is characterised by diffuse leukoencephalopathy without contrast enhancement, often causes diagnostic confusion1 with suspected diagnoses ranging from Binswanger’s disease to leukoencephalopathy or encephalomyelitis. Here we report a patient with subacute dementia and diffuse bilateral white matter changes in the cerebral hemispheres and additional involvement of the brainstem, basal ganglia and thalamus on MRI. Initially, she was considered to suffer from an autoimmune encephalitis, transiently responded to immunosuppression but then developed multiple solid appearing cerebral lymphomas.

Footnotes

  • Competing interests: None.

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