Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
권호 표지
DOI QR코드

DOI QR Code

Brain Magnetic Resolution Imaging to Diagnose Bing-Neel Syndrome

  • Kim, Ho-Jung (Department of Neurology, Korea University College of Medicine) ;
  • Suh, Sang-Il (Department of Radiology, Korea University College of Medicine) ;
  • Kim, Joo-Han (Department of Neurosurgery, Korea University College of Medicine) ;
  • Kim, Byung-Jo (Department of Neurology, Korea University College of Medicine)
  • Published : 2009.12.28
Download PDF
⟨ Previous Next ⟩

Abstract

Radiologic findings of Bing-Neel syndrome, which is an extremely uncommon complication resulting from malignant lymphocyte infiltration into the central nervous system (CNS) in patients with Waldenstr$\ddot{o}$m's macroglobulinemia (WM), have been infrequently reported due to extreme rarity of the case. A 75-year-old man with WM presented at a neurology clinic with progressive gait and memory disturbances, and dysarthria of 2 months duration. Cerebrospinal fluid and serum protein electrophoresis and immunofixation electrophoresis showed IgM kappa-type monoclonal gammopathy. Brain magnetic resonance imaging revealed multifocal, hyperintense lesions on T2 weighted-images. Brain diffusion-weighted imaging (DWI) demonstrated hyperintensities in cerebral and cerebellar lesions that appeared isointense on apparent diffusion coefficient maps, which were compatible with vasogenic edema. Although histologic analysis is a confirmative study to prove direct cell infiltration into the brain, brain MRI with DWI may be a good supportive study to diagnose Bing-Neel syndrome.

Keywords

References

  1. Arias M, Pereiro Zabala I, Requena Caballero I, Sesar Ignacio A, Arias Rivas S, Villamayor Blanco B : [Rapidly progressing dementia as the presenting symptom of Waldenstr$\ddot{o}$m's macroglobulinemia : findings from magnetic resonance imaging of the brain in Bing Neel syndrome.] Rev Neurol 38 : 640-642, 2004
  2. Bang SM, Park SR, Park SH, Cho EK, Yoon SS, Shin DB, et al. : Clinical features of Waldenstrom macroglobulinemia in Korea. Korean J Intern Med 19 : 137-140, 2004 https://doi.org/10.3904/kjim.2004.19.3.137
  3. Bing J, Neel A : Two cases of hyperglobulinemia with affection of the central nervous system on a toxi-infectious basis. Acta Med Scand 88 : 492-506, 1936 https://doi.org/10.1111/j.0954-6820.1936.tb12571.x
  4. Delgado J, Canales MA, Garcia B, Alvarez-Ferreira J, Garcia-Grande A, Hernandez-Navarro F : Radiation therapy and combination of cladribine, cyclophosphamide, and prednisone as treatment of Bing-Neel syndrome : case report and review of the literature. Am J Hematol 69 : 127-131, 2002 https://doi.org/10.1002/ajh.10023
  5. Drappatz J, Akar S, Fisher DC, Samuels MA, Kesari S : Imaging of Bing-Neel syndrome. Neurology 70 : 1364, 2008 https://doi.org/10.1212/01.wnl.0000309212.22661.84
  6. Edgar R, Dutcher TF : Histopathology of the Bing-Neel syndrome. Neurology 11 : 239-245, 1961 https://doi.org/10.1212/WNL.11.3.239
  7. Gertz MA, Fonseca R, Rajkumar SV : Waldenstrom's macroglobulinemia. Oncologist 5 : 63-67, 2000 https://doi.org/10.1634/theoncologist.5-1-63
  8. Ghobrial IM, Gertz MA, Fonseca R : Waldenstrom macroglobulinaemia. Lancet Oncol 4 : 679-685, 2003 https://doi.org/10.1016/S1470-2045(03)01246-4
  9. Imai F, Fujisawa K, Kiya N, Ninomiya T, Ogura Y, Mizoguchi Y, et al. : Intracerebral infiltration by monoclonal plasmacytoid cells in Waldenstrom's macroglobulinemia--case report. Neurol Med Chir (Tokyo) 35 : 575-579, 1995 https://doi.org/10.2176/nmc.35.575
  10. Kim HD, Shin KC, Cho HS, Kim MK, Lee KH, Hyun MS : Therapeutic experience of Bing-Neel Syndrome associated with Waldenstrom's macroglobulinemia. J Korean Med Sci 22 : 1079-1081, 2007 https://doi.org/10.3346/jkms.2007.22.6.1079
  11. Logothetis J, Silverstein P, Coe J : Neurologic aspects of Waldenstrom's macroglobulinemia; report of a case. Arch Neurol 3 : 564-573, 1960 https://doi.org/10.1001/archneur.1960.00450050084010
  12. Mehta J, Singhal S : Hyperviscosity syndrome in plasma cell dyscrasias. Semin Thromb Hemost 29 : 467-471, 2003 https://doi.org/10.1055/s-2003-44554
  13. Shimizu K, Fujisawa K, Yamamoto H, Mizoguchi Y, Hara K : Importance of central nervous system involvement by neoplastic cells in a patient with Waldenstr$\ddot{o}$m's macroglobulinemia developing neurologic abnormalities. Acta Haematol 90 : 206-208, 1993 https://doi.org/10.1159/000204461
  14. Wagner KR, Dean C, Beiler S, Bryan DW, Packard BA, Smulian AG, et al. : Plasma infusions into porcine cerebral white matter induce early edema, oxidative stress, pro-inflammatory cytokine gene expression and DNA fragmentation : implications for white matter injury with increased blood-brain-barrier permeability. Curr Neurovasc Res 2 : 149-155, 2005 https://doi.org/10.2174/1567202053586785

Cited by

  1. Bing–Neel Syndrome in a Patient with Waldenstrom's Macroglobulinemia: A Challenging Diagnosis in the Face of Normal Brain Imaging vol.20, pp.10, 2014, https://doi.org/10.1111/cns.12311
  2. Late‐Onset Bing‐Neel Syndrome Associated with Delirium and Lewy Body Dementia vol.62, pp.11, 2014, https://doi.org/10.1111/jgs.13124
  3. Isolated Optic Nerve, Chiasm, and Tract Involvement in Bing–Neel Syndrome vol.34, pp.4, 2009, https://doi.org/10.1097/wno.0000000000000138
  4. Bing-Neel Syndrome Case Report: A Previously Undocumented IgG Variant with MRI, PET/CT, and PET/MRI Imaging vol.2016, pp.None, 2016, https://doi.org/10.1155/2016/3931709
  5. Intracranial venous sinus thrombosis as unusual presentation of Bing-Neel syndrome: case illustration vol.127, pp.5, 2009, https://doi.org/10.3171/2016.9.jns161678
  6. Intracranial venous sinus thrombosis as unusual presentation of Bing-Neel syndrome: case illustration vol.127, pp.5, 2009, https://doi.org/10.3171/2016.9.jns161678
  7. Efficacy of ibrutinib as first-line treatment of tumoral Bing-Neel syndrome vol.59, pp.11, 2009, https://doi.org/10.1080/10428194.2018.1441409
  8. Central Nervous System Involvement by Waldenstrom Macroglobulinemia: A Case Report of the Bing–Neel Syndrome vol.2019, pp.None, 2009, https://doi.org/10.1155/2019/4075960
  9. Bing-Neel syndrome: A case reports vol.27, pp.7, 2009, https://doi.org/10.1177/1078155220983426
  10. Primary central nervous system diffuse large B‐cell lymphoma masqueraded as Bing‐Neel syndrome: Steps in management and review of future directions vol.9, pp.12, 2009, https://doi.org/10.1002/ccr3.5113