A case of primary lymphoma in bilateral middle cerebellar peduncles resembling demyelinating disease / 中华神经科杂志

ABSTRACT

Primary central nervous system lymphoma (PCNSL) is a rare,extranodal form of non-Hodgkin lymphoma that is confined to the central nervous system.It mainly involves the deep brain white matter,the lateral ventricle and the corpus callosum.A decline in cognitive function and headache are the typical clinical manifestations of the disease.We report a patient with PCNSL in bilateral middle cerebellar peduncles,whose clinical manifestations were only dizziness and unstable walking.Brain MRI manifestations were not typical in early time,with symmetrical hypointensity lesions on T1-weighted imaging,hyperintensity lesions on T2-weighted imaging,and edema zone around on FLAIR imaging.Enhanced scan showed marginal contrast enhancement,but no significant occupying effect.These changes were similar to the multiple characteristics of multiple sclerosis.The history of autoimmune diseases and cerebrospinal fluid examination highly indicated demyelinating disease.The differences of clinical manifestations,MRI characteristics,diagnosis,treatment and prognosis between PCNSL in bilateral middle cerebellar peduncles and multiple sclerosis were analyzed to imorove the understanding of the disease in clinical practice.