Lymphomatosis cerebri with coexistent anti‐N‐methyl‐D‐aspartate receptor antibody: A case report

N Rattanathamsakul, T Ongphichetmetha… - …, 2023 - Wiley Online Library
N Rattanathamsakul, T Ongphichetmetha, P Weerachotisakul, N Tisavipat, P Cheunsuchon
Neuropathology, 2023Wiley Online Library
Diagnosis of lymphomatosis cerebri (LC) is usually delayed because of its rarity and the
need for pathological confirmation. The association of LC with humoral immunity has
scarcely been reported. Herein, we present a woman with a 2‐week history of dizziness and
gait ataxia, followed by diplopia, altered mental status, and spasticity of all limbs. Magnetic
resonance imaging (MRI) of the brain showed multifocal lesions involving bilateral
subcortical white matter, deep gray structures, and brainstem. Oligoclonal bands and anti‐N …
Diagnosis of lymphomatosis cerebri (LC) is usually delayed because of its rarity and the need for pathological confirmation. The association of LC with humoral immunity has scarcely been reported. Herein, we present a woman with a 2‐week history of dizziness and gait ataxia, followed by diplopia, altered mental status, and spasticity of all limbs. Magnetic resonance imaging (MRI) of the brain showed multifocal lesions involving bilateral subcortical white matter, deep gray structures, and brainstem. Oligoclonal bands and anti‐N‐methyl‐D‐aspartate receptor (NMDAR) antibodies were present in cerebrospinal fluid (CSF) twice. She was initially treated with methylprednisolone but still worsening. A stereotactic brain biopsy confirmed the diagnosis of LC. This is a report on the distinctive coexistence of the rare CNS lymphoma variant and the anti‐NMDAR antibody.
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