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首页> 外文期刊>Journal of neuro-ophthalmology: Official journal of the North American Neuro-Ophthalmology Society >Episodic Visual Distortions and Stroke-Like Symptoms in a 56-Year-Old Man With Intravascular Lymphoma
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Episodic Visual Distortions and Stroke-Like Symptoms in a 56-Year-Old Man With Intravascular Lymphoma

机译：在一个56岁的男子血管内淋巴瘤的56岁男子中，血管内患者的脑卒中症状

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摘要

A healthy 56-year-old man presented with vision changes and left upper extremity motor and sensory changes. MRI of the brain without contrast was significant for multifocal areas of restricted diffusion in multiple vascular territories. Neuro-Ophthalmic evaluation revealed an inferonasal visual field defect in the left eye, thickened choroid on optical coherence tomography, and bilateral delayed arteriovenous and choroidal filling on fluorescein angiogram. Repeat MRI demonstrated interval enlargement of many of the same foci of abnormal diffusion-weighted imaging signal. Computed tomography of the abdomen and pelvis revealed 3 distinct lobulated retroperitoneal masses that were biopsied and found to be consistent with diffuse large B-cell lymphoma. Brain biopsy specimens showed intravascular lymphocytes, confirming a diagnosis of intravascular lymphoma (IVL). In this diagnostically challenging case, a link was established between the presence of multiple strokes (some of which showed slow evolution over time) and retinochoroidal hypoperfusion, which provided a critical clue to the ultimate diagnosis of IVL.
机译：一个健康的56岁男子，呈现视觉变化，左侧肢体电机和感官变化。没有对比的大脑MRI对于多个血管领土的受限制扩散的多焦点区域具有重要意义。神经眼科评价揭示了左眼左眼的差异视野缺陷，光学相干断层扫描的增厚脉络膜，以及双侧延迟动脉和脉络膜填充荧光素血管造影。重复MRI显示出异常扩散加权成像信号的许多相同焦点的间隔放大。腹部和骨盆的计算断层扫描显示了3种不同的裂解腹膜内肿块，其活检并发现与弥漫性大B细胞淋巴瘤一致。脑活检标本显示血管内淋巴细胞，证实血管内淋巴瘤（IVL）的诊断。在这个诊断上具有挑战性的情况下，在多次中风的存在（其中一些显示出随时间的缓慢演变）和视网膜体低血量灌注之间建立了一个链接，这为IVL的最终诊断提供了临界线索。

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