脳生検で診断し得た多発脳出血を伴った血管内大細胞型B細胞リンパ腫の1例

症例は53歳女性，左上肢の間代性痙攣を認め入院した．頭部MRIで大脳に複数のFLAIR高信号，磁化率強調画像（susceptibility-weighted imaging; SWI）で多発する微小な低信号病変が見られ，抗痙攣薬の内服を開始した．しかし痙攣発作が再発し，頭部MRIで大脳にさらにSWI低信号の病変が新規に出現したため，脳生検し，出血を伴った血管内大細胞型B細胞リンパ腫（intravascular large B-cell lymphoma; IVLBCL）と診断した．IVLBCLは典型的な多発梗塞性病変だけでなく出血性病変でもIVLBCLを鑑別疾患の一つとして列挙する必要がある．...

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Published in臨床神経学 Vol. 60; no. 3; pp. 206 - 212
Main Authors 鈴木, 博義, 矢浦, 一磨, 中村, 貴彬, 渡辺, 源也, 鈴木, 靖士, 突田, 健一
Format Journal Article
LanguageJapanese
Published 日本神経学会 2020
Subjects
磁化率強調画像（SWI）
脳出血
脳生検
血管内リンパ腫（IVL）
血管内大細胞型B細胞リンパ腫（IVLBCL）
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ISSN0009-918X
1882-0654
DOI10.5692/clinicalneurol.cn-001373

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Abstract 症例は53歳女性，左上肢の間代性痙攣を認め入院した．頭部MRIで大脳に複数のFLAIR高信号，磁化率強調画像（susceptibility-weighted imaging; SWI）で多発する微小な低信号病変が見られ，抗痙攣薬の内服を開始した．しかし痙攣発作が再発し，頭部MRIで大脳にさらにSWI低信号の病変が新規に出現したため，脳生検し，出血を伴った血管内大細胞型B細胞リンパ腫（intravascular large B-cell lymphoma; IVLBCL）と診断した．IVLBCLは典型的な多発梗塞性病変だけでなく出血性病変でもIVLBCLを鑑別疾患の一つとして列挙する必要がある．
AbstractList 症例は53歳女性，左上肢の間代性痙攣を認め入院した．頭部MRIで大脳に複数のFLAIR高信号，磁化率強調画像（susceptibility-weighted imaging; SWI）で多発する微小な低信号病変が見られ，抗痙攣薬の内服を開始した．しかし痙攣発作が再発し，頭部MRIで大脳にさらにSWI低信号の病変が新規に出現したため，脳生検し，出血を伴った血管内大細胞型B細胞リンパ腫（intravascular large B-cell lymphoma; IVLBCL）と診断した．IVLBCLは典型的な多発梗塞性病変だけでなく出血性病変でもIVLBCLを鑑別疾患の一つとして列挙する必要がある．
Author 渡辺, 源也
鈴木, 博義
中村, 貴彬
突田, 健一
鈴木, 靖士
矢浦, 一磨
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References 7) Xia C, Lang SY, Li XM, et al. Intravascular lymphomatosis with recurrent cerebral hemorrhages. Neurol India 2009;57:817-819.
8) Passarin MG, Wen PY, Vattemi E, et al. Intravascular lymphomatosis and intracerebral haemorrhage. Neurol Sci 2010;31:793-797.
6) Ganguly S. Acute intracerebral hemorrhage in intravascular lymphoma. A serious infusion related adverse event of rituximab. Am J Clin Oncol 2007;30:211-212.
15) 橋詰良夫．血管内リンパ腫の病理．Brain Nerve 2011;63:459-466.
1) Shimada K, Kinoshita T, Naoe T, et al. Presentation and management of intravascular large B-cell lymphoma. Lancet Oncol 2009;10:895-902.
3) Fonkem E, Dayawansa S, Stroberg E, et al. Neurological presentations of intravascular lymphoma (IVL): meta-analysis of 654 patients. BMC Neurol 2016;16:9.
9) Marino D, Sicurelli F, Cerase A, et al. Fulminant intravascular lymphomatosis mimicking acute haemorrhagic leukoencephalopathy. J Neurol Sci 2012;320:141-144.
10) Haninger DM, Davis TA, Parker JR, et al. Intravascular Large B-Cell lymphoma presenting as acute hemorrhagic cerebral infarct with delirium. Ann Clin Lab Sci 2013;43:305-310.
5) Yamamoto A, Kikuchi Y, Homma K, et al. Characteristics of intravascular large B-cell lymphoma on cerebral MR imaging. AJNR Am J Neuroradiol 2012;33:292-296.
4) Williams RL, Meltzer CC, Smirniotopoulos JG, et al. Cerebral MR imaging in intravascular lymphomatosis. AJNR Am J Neuroradiol 1998;19:427-431.
12) Suzuki Y, Tanaka H, Suyama K, et al. Secondary central nerve system lymphoma with intratumoral hemorrhage suggested as intravascular lymphoma by autopsy: A case report. J Clin Med Res 2017;9:953-957.
11) Jethwani DP, Yadav R, Chickabasaviah YT, et al. A 58-year-old lady with progressive neurological syndrome: Presence of an intravascular lymphoma. Neurol India 2015;63:225-229.
14) 津田　曜，小栗卓也，櫻井圭太ら．MRI磁化率強調画像で大脳に多発する低信号域を認めた血管内大細胞型B細胞リンパ腫の1例．臨床神経 2017;57:504-508.
2) Ferreri AJ, Campo E, Seymour JF, et al. Intravascular lymphoma: clinical presentation, natural history, management and prognostic factors in a series of 38 cases, with special emphasis on the ‘cutaneous variant’. Br J Haematol 2004;127:173-183.
13) Uzuka T, Higuchi F, Matsuda H, et al. Intravascular lymphoma with an acute course of cerebellar hemorrhage: A case report. Neurol Med Chir (Tokyo) 2018;58:96-100.
References_xml – reference: 6) Ganguly S. Acute intracerebral hemorrhage in intravascular lymphoma. A serious infusion related adverse event of rituximab. Am J Clin Oncol 2007;30:211-212.
– reference: 3) Fonkem E, Dayawansa S, Stroberg E, et al. Neurological presentations of intravascular lymphoma (IVL): meta-analysis of 654 patients. BMC Neurol 2016;16:9.
– reference: 9) Marino D, Sicurelli F, Cerase A, et al. Fulminant intravascular lymphomatosis mimicking acute haemorrhagic leukoencephalopathy. J Neurol Sci 2012;320:141-144.
– reference: 4) Williams RL, Meltzer CC, Smirniotopoulos JG, et al. Cerebral MR imaging in intravascular lymphomatosis. AJNR Am J Neuroradiol 1998;19:427-431.
– reference: 11) Jethwani DP, Yadav R, Chickabasaviah YT, et al. A 58-year-old lady with progressive neurological syndrome: Presence of an intravascular lymphoma. Neurol India 2015;63:225-229.
– reference: 2) Ferreri AJ, Campo E, Seymour JF, et al. Intravascular lymphoma: clinical presentation, natural history, management and prognostic factors in a series of 38 cases, with special emphasis on the ‘cutaneous variant’. Br J Haematol 2004;127:173-183.
– reference: 15) 橋詰良夫．血管内リンパ腫の病理．Brain Nerve 2011;63:459-466.
– reference: 1) Shimada K, Kinoshita T, Naoe T, et al. Presentation and management of intravascular large B-cell lymphoma. Lancet Oncol 2009;10:895-902.
– reference: 12) Suzuki Y, Tanaka H, Suyama K, et al. Secondary central nerve system lymphoma with intratumoral hemorrhage suggested as intravascular lymphoma by autopsy: A case report. J Clin Med Res 2017;9:953-957.
– reference: 5) Yamamoto A, Kikuchi Y, Homma K, et al. Characteristics of intravascular large B-cell lymphoma on cerebral MR imaging. AJNR Am J Neuroradiol 2012;33:292-296.
– reference: 7) Xia C, Lang SY, Li XM, et al. Intravascular lymphomatosis with recurrent cerebral hemorrhages. Neurol India 2009;57:817-819.
– reference: 14) 津田　曜，小栗卓也，櫻井圭太ら．MRI磁化率強調画像で大脳に多発する低信号域を認めた血管内大細胞型B細胞リンパ腫の1例．臨床神経 2017;57:504-508.
– reference: 10) Haninger DM, Davis TA, Parker JR, et al. Intravascular Large B-Cell lymphoma presenting as acute hemorrhagic cerebral infarct with delirium. Ann Clin Lab Sci 2013;43:305-310.
– reference: 8) Passarin MG, Wen PY, Vattemi E, et al. Intravascular lymphomatosis and intracerebral haemorrhage. Neurol Sci 2010;31:793-797.
– reference: 13) Uzuka T, Higuchi F, Matsuda H, et al. Intravascular lymphoma with an acute course of cerebellar hemorrhage: A case report. Neurol Med Chir (Tokyo) 2018;58:96-100.
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Snippet 症例は53歳女性，左上肢の間代性痙攣を認め入院した．頭部MRIで大脳に複数のFLAIR高信号，磁化率強調画像（susceptibility-weighted imaging; SWI）で多発する微小な低信...
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SubjectTerms 磁化率強調画像（SWI）
脳出血
脳生検
血管内リンパ腫（IVL）
血管内大細胞型B細胞リンパ腫（IVLBCL）
Title 脳生検で診断し得た多発脳出血を伴った血管内大細胞型B細胞リンパ腫の1例
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Volume 60
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