Behavioural and cognitive changes in a patient with leukoencephalopathy due to lymphomatosis cerebri
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https://orcid.org/0000-0003-0200-5086
Abstract
We present the case of a 59-year-old woman with a history of facial hemangioma, with progressive cognitive impairment over three months (MoCA score 15/30) combined with abulia, unmotivated crying, non-fluent speech, limb paratonia, bilateral Hoffman and palmar-mental reflexes, and apraxic gait. A brain MRI was performed on admission, revealing an extensive lesion involving the periventricular, subcortical, and deep white matter. Multivoxel spectroscopy showed an increase in choline and a decrease in NAA. Laboratory tests specific for viral infections, syphilis, HIV, LDH, and CEA were normal. In addition, CSF was normal, and CSF cytology and flow cytometry were negative. Cerebral angiography ruled out the presence of arteriovenous fistula or abnormal anastomosis. A biopsy determined that the lesion was B-cell non-Hodgkin lymphoma (CD20+). Due to its extent, a definitive diagnosis of cerebral lymphomatosis was made. No primary lesion was found.
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