Diagnosis:
Suggested by MRI and confirmed by pathology (brain biopsy/resection)
Pathology:
- A type of diffuse large B cell nonHodgkin’s lymphoma
- B lymphocytis, granuloma involving the vessels (angiocentric & destruction of vessels) & brain parenchyma. Reactive T cells, Histiocytes
- EBV positive B cells
- Infarcts
Clinical features:
- Affects lungs & skin, CNS, Peripheral nervous system (cranial & limbs),
- Usually affects the lungs before the CNS
Findings on Investigations:
MRI:
- Infarcts
- T2/FLAIR: white matter lesions, brainstem or supratentorial
- Enhancement of lesions: enhancement along perivascular spaces or ring enhancement or punctate enhancement
Catheter Angiogram: appearance of vasculitis