DOI QR코드

DOI QR Code

A Case of Cerebellopontine Angle Diffuse Large B Cell Lymphoma in a Systemic Lupus Erythematosus Patient

전신홍반루푸스 환자에서 발생한 소뇌다리뇌각 림프종 1예

  • Bae, Soo Hyun (Department of Internal Medicine, Daegu Fatima Hospital) ;
  • Kwon, Moon Hyuk (Department of Internal Medicine, Daegu Fatima Hospital) ;
  • Kim, Min Hee (Department of Internal Medicine, Daegu Fatima Hospital) ;
  • Lee, Sang Ah (Department of Internal Medicine, Daegu Fatima Hospital) ;
  • Lee, Jung Lim (Department of Internal Medicine, Daegu Fatima Hospital) ;
  • Han, Man Hun (Department of Pathology, Daegu Fatima Hospital) ;
  • Yun, Sang Mo (Department of Therapeutic Radiology, Daegu Fatima Hospital)
  • 배수현 (대구파티마병원 내과) ;
  • 권문혁 (대구파티마병원 내과) ;
  • 김민희 (대구파티마병원 내과) ;
  • 이상아 (대구파티마병원 내과) ;
  • 이정림 (대구파티마병원 내과) ;
  • 한만훈 (대구파티마병원 병리과) ;
  • 윤상모 (대구파티마병원 치료방사선과)
  • Received : 2012.12.27
  • Accepted : 2013.07.25
  • Published : 2014.01.01

Abstract

Patients with systemic lupus erythematosus (SLE) are at higher risk for malignant lymphomas, among which, however, primary CNS lymphoma (PCNSL) is rare. PCNSL usually occurs within the cerebral hemispheres, occasionally in the cerebellum, but rarely in the cerebellopontine angle (CPA). We report our findings in a 45-year-old man with SLE on azathioprine, who presented with sudden hearing loss and dysphagia. The brain MRI revealed a mass lesion in the right CPA. A biopsy was performed and the final diagnosis was diffuse large B cell lymphoma. This is the first report of CPA lymphoma in a SLE patient. The patient was treated with whole brain radiotherapy only because of recurrent pneumonia that was a result of dysphagia from permanent cranial nerve injury. He has been in complete remission for over 10 months.

전신홍반루푸스 환자에게서 림프종의 발생위험은 일반 인구에 비해 3배 이상 증가하나 원발성 중추신경계 림프종은 상대적으로 드물다. 비록 질환의 발생빈도가 낮지만 신경학적인 증상이 있을 때 가능성을 반드시 고려해야 하며 뇌자기공명영상을 신속하게 시행하고 조직 검사를 통해 확실한 진단을 하는 것이 치료에 도움이 될 수 있다. 저자들은 청력저하를 주소로 내원한 면역억제제를 복용하고 있던 전신홍반루푸스 환자가 우측 소뇌다리뇌각, 광범위큰B세포림프종으로 진단받고 전뇌방사선 치료를 시행하여 완전관해를 이룬 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

Keywords

References

  1. Woolf AS, Conway G. Systemic lupus erythematosus and primary cerebral lymphoma. Postgrad Med J 1987;63:569-571. https://doi.org/10.1136/pgmj.63.741.569
  2. Cras P, Franckx C, Martin JJ. Primary intracerebral lymphoma in systemic lupus erythematosus treated with immunosuppressives. Clin Neuropathol 1989;8:200-205.
  3. Tomabechi M, Daita G, Ohgami S, Yonemasu Y, Maekawa I. A case of primary intracerebral malignant lymphoma in systemic lupus erythematosus. No Shinkei Geka 1992;20:429-432.
  4. Pisoni CN, Grinberg AR, Plana JL, Freue RD, Manni JA, Paz L. Primary central nervous system lymphoma in a patient with systemic lupus erythematosus. Medicina (B Aires) 2003;63:221-223.
  5. Dasgupta N, Gelber AC, Racke F, Fine DM. Central nervous system lymphoma associated with mycophenolate mofetil in lupus nephritis. Lupus 2005;14:910-913. https://doi.org/10.1191/0961203303lu2179cr
  6. Finelli PF, Naik K, DiGiuseppe JA, Prasad A. Primary lymphoma of CNS, mycophenolate mofetil and lupus. Lupus 2006;15:886-888. https://doi.org/10.1177/0961203306071431
  7. Biasiotta A, Frati A, Salvati M, et al. Primary hypothalamic lymphoma in a patient with systemic lupus erythematosus: case report and review of the literature. Neurol Sci 2010;31:647-652. https://doi.org/10.1007/s10072-010-0338-x
  8. Tsang HH, Trendell-Smith NJ, Wu AK, Mok MY. Diffuse large B-cell lymphoma of the central nervous system in mycophenolate mofetil-treated patients with systemic lupus erythematosus. Lupus 2010;19:330-333. https://doi.org/10.1177/0961203309347921
  9. Sacho RH, Kogels M, du Plessis D, Jowitt S, Josan VA. Primary diffuse large B-cell central nervous system lymphoma presenting as an acute space-occupying subdural mass. J Neurosurg 2010;113:384-387. https://doi.org/10.3171/2010.2.JNS091554
  10. Svobodova B, Hruskova Z, Rysava R, Tesar V. Brain diffuse large B-cell lymphoma in a systemic lupus erythematosus patient treated with immunosuppressive agents including mycophenolate mofetil. Lupus 2011;20:1452-1454. https://doi.org/10.1177/0961203311412413

Cited by

  1. Chronic Intractable Dizziness and Hearing Loss in Patient with Systemic Lupus Erythematosus as a Sign of Primary Central Nervous System Lymphoma vol.38, pp.3, 2014, https://doi.org/10.17340/jkna.2020.3.14