RESUMO
Primary central nervous system vasculitis (PCNSV) is an uncommon vasculitis restricted to the small- and medium-sized vessels in the brain and spinal cord. Previously, only 9 cases have been reported that initially manifested as an isolated spinal cord lesion with subsequent brain involvement, where the longest interval from the onset to brain involvement was 1 year and 11 months. We herein report the case of an isolated spinal cord lesion with subsequent brain involvement appearing seven years and five months later. This case shows that brain lesions can develop after an extended interval from spinal onset in PCNSV.
Assuntos
Encéfalo/patologia , Doenças da Medula Espinal/tratamento farmacológico , Doenças da Medula Espinal/patologia , Medula Espinal/patologia , Esteroides/uso terapêutico , Vasculite do Sistema Nervoso Central/patologia , Humanos , Japão , Masculino , Pessoa de Meia-Idade , Fatores de TempoAssuntos
Linfoma/diagnóstico por imagem , Linfoma/patologia , Raízes Nervosas Espinhais/diagnóstico por imagem , Idoso , Imagem de Difusão por Ressonância Magnética , Humanos , Região Lombossacral/patologia , Linfoma/complicações , Masculino , Doenças Musculares/diagnóstico por imagem , Doenças Musculares/etiologia , Dor/diagnóstico por imagem , Dor/etiologia , Radiculopatia/diagnóstico por imagem , Radiculopatia/etiologia , Tomógrafos ComputadorizadosRESUMO
Meningeal carcinomatosis is a well-known complication of malignant neoplasms. We report a case of meningeal carcinomatosis of 2 months' duration in a 22-year-old man, in whom the initial symptom was gradually worsening headache. Postmortem examination revealed infiltrating adenocarcinoma of the stomach. Carcinoma cells showed diffuse spread to the subarachnoid space of the brain and spinal cord. In many places, subarachnoid tumor cells had infiltrated to the cranial and spinal nerves. Moreover, carcinoma cells in the nerve roots extended to the parenchyma of the brain and spinal cord beyond the CNS-peripheral nervous system junction. These findings suggest that cranial and spinal nerve roots can be a possible route of parenchymal invasion in meningeal carcinomatosis.