Subject(s)
Antibodies, Monoclonal, Humanized/adverse effects , Antineoplastic Agents/adverse effects , Blood Platelet Disorders/chemically induced , Breast Neoplasms/drug therapy , Maytansine/analogs & derivatives , Skin Diseases/chemically induced , Thrombocytopenia/chemically induced , Vasculitis/chemically induced , Ado-Trastuzumab Emtansine , Blood Platelet Disorders/pathology , Drug-Related Side Effects and Adverse Reactions , Female , Humans , Maytansine/adverse effects , Skin Diseases/pathology , Thrombocytopenia/pathology , Trastuzumab , Vasculitis/pathologyABSTRACT
BACKGROUND: A 77-year-old retired research pharmacologist with a long-standing history of anemia and a recent pathologically confirmed diagnosis of myelodysplastic syndrome was referred to a stroke unit for evaluation of slowly progressive cognitive deterioration, confusion and paroxysmal stroke-like episodes. A previous neurological work-up had revealed no noteworthy abnormalities except for chronic bilateral caudate infarctions seen on MRI and CT examinations of the brain. INVESTIGATIONS: Physical examination, laboratory testing, brain MRI scanning, EEG, transesophageal echocardiography, cerebral angiography, CT scanning, and brain biopsy. DIAGNOSIS: Intravascular lymphomatosis of the brain. MANAGEMENT: Combined chemotherapy with CHOP (cyclophosphamide, doxorubicin, vincristine and prednisone) and rituximab.
