Case Report
Volume: 7 | Issue: 6 | Published: Aug 17, 2023 | Pages: 132 - 136 | DOI: 10.24911/ejmcr/173-1679317215
Uncredited intravascular large B cell lymphoma involving central nervous system: a great masquerader
Authors:
Shu Ann Hon
, Jie Siang See
, Jack Son Wee
, Yu Jin Tee
, Ehram Jamien
, Hamdi Achok
, Soo Min Lim
Article Info
Authors
Jie Siang See
Department of Internal Medicine, Hospital Sultanah Aminah, Johor Bahru, Malaysia
Jack Son Wee
Department of Internal Medicine, Hospital Sultanah Aminah, Johor Bahru, Malaysia
Yu Jin Tee
Department of Radiology, Hospital Sultanah Aminah, Johor Bahru, Malaysia
Ehram Jamien
Department of Pathology, Hospital Sultanah Aminah, Johor Bahru, Malaysia
Hamdi Achok
Department of Internal Medicine, Hospital Sultanah Aminah, Johor Bahru, Malaysia
Soo Min Lim
Department of Internal Medicine, Hospital Sultanah Aminah, Johor Bahru, Malaysia.
Publication History
Received: March 21, 2023
Revised: June 17, 2023
Accepted: June 17, 2023
Published: August 17, 2023
Abstract
Background: Intravascular large B-cell lymphoma (IVLBCL) is infrequent and aggressive, clinically depicted by an almost exclusive growth of large cells within the lumen of blood vessels of all sizes. The clinical manifestations are diverse, encompassing many non-specific signs and symptoms such as fever of unknown origin, neurological symptoms, and skin lesions. Case Presentation: We report a case of a 49-year-old lady with unusual IVLBCL of the central nervous system. She presented with rapidly progressive dementia preceded by seizures and a short history of altered sensorium. There were no cutaneous lesions. Plain computed tomography brain showed no significant abnormalities. Cerebrospinal fluid analysis was normal except for mildly raised protein. Antinuclear antibody was positive 1:320 but the remaining autoimmune workups were negative. Electroencephalogram showed cortical dysfunction with occasional sharp wave at the right frontoparietal region. Other dementia workups were unremarkable. Magnetic resonance imaging brain revealed non-enhanced biparietal gyri hyperintensities which may represent encephalitis changes. She was empirically treated for viral encephalitis, however, there were still recurrent seizures despite adequate anti-seizure medications with minimal improvement of symptoms. Subsequent admissions noticed bicytopenia with elevated lactate dehydrogenase. Bone marrow aspirations and trephine biopsy disclosed High-Grade Mature B Cell Lymphoma germinal center B-cell Type. She was subsequently managed by the hematology team and started with conventional rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone therapy. Fortunately, she is currently on the road to recovery. Conclusion: High index of suspicion is warranted to diagnose early in order to have a better prognosis.
Keywords: IVLBCL, rapidly progressive dementia, seizures, altered sensorium, bicytopenia, green
Pubmed Style
Shu Ann Hon, Jie Siang See, Jack Son Wee, Yu Jin Tee, Ehram Jamien, Hamdi Achok, Soo Min Lim. Uncredited intravascular large B cell lymphoma involving central nervous system: a great masquerader. EJMCR. 2023; 17 (August 2023): 132-136. doi:10.24911/ejmcr/173-1679317215
Web Style
Shu Ann Hon, Jie Siang See, Jack Son Wee, Yu Jin Tee, Ehram Jamien, Hamdi Achok, Soo Min Lim. Uncredited intravascular large B cell lymphoma involving central nervous system: a great masquerader. https://ejmcr.com/articles/1062 [Access: October 28, 2024]. doi:10.24911/ejmcr/173-1679317215
AMA (American Medical Association) Style
Shu Ann Hon, Jie Siang See, Jack Son Wee, Yu Jin Tee, Ehram Jamien, Hamdi Achok, Soo Min Lim. Uncredited intravascular large B cell lymphoma involving central nervous system: a great masquerader. EJMCR. 2023; 17 (August 2023): 132-136. doi:10.24911/ejmcr/173-1679317215
Vancouver/ICMJE Style
Shu Ann Hon, Jie Siang See, Jack Son Wee, Yu Jin Tee, Ehram Jamien, Hamdi Achok, Soo Min Lim. Uncredited intravascular large B cell lymphoma involving central nervous system: a great masquerader. EJMCR. (2023), [cited October 28, 2024]; 17 (August 2023): 132-136. doi:10.24911/ejmcr/173-1679317215
Harvard Style
Shu Ann Hon, Jie Siang See, Jack Son Wee, Yu Jin Tee, Ehram Jamien, Hamdi Achok, Soo Min Lim (2023) Uncredited intravascular large B cell lymphoma involving central nervous system: a great masquerader. EJMCR, 17 (August 2023): 132-136. doi:10.24911/ejmcr/173-1679317215
Chicago Style
Shu Ann Hon, Jie Siang See, Jack Son Wee, Yu Jin Tee, Ehram Jamien, Hamdi Achok, Soo Min Lim. "Uncredited intravascular large B cell lymphoma involving central nervous system: a great masquerader." 17 (2023), 132-136. doi:10.24911/ejmcr/173-1679317215
MLA (The Modern Language Association) Style
Shu Ann Hon, Jie Siang See, Jack Son Wee, Yu Jin Tee, Ehram Jamien, Hamdi Achok, Soo Min Lim. "Uncredited intravascular large B cell lymphoma involving central nervous system: a great masquerader." 17.August 2023 (2023), 132-136. Print. doi:10.24911/ejmcr/173-1679317215
APA (American Psychological Association) Style
Shu Ann Hon, Jie Siang See, Jack Son Wee, Yu Jin Tee, Ehram Jamien, Hamdi Achok, Soo Min Lim (2023) Uncredited intravascular large B cell lymphoma involving central nervous system: a great masquerader. , 17 (August 2023), 132-136. doi:10.24911/ejmcr/173-1679317215