Multiple cerebral lesions in a patient with refractory celiac disease:A case report
作者机构：Department of Internal Medicine V(Hematology and Medical Oncology)Medical University InnsbruckInnsbruck 6020Austria InnPath GmbHInstitute of PathologyInnsbruck 6020Austria Ottakring ClinicInstitute of Pathology and MicrobiologyVienna 1160Austria Department of Internal Medicine I(GastroenterologyHepatologyEndocrinology and Metabolism)Medical University InnsbruckInnsbruck 6020Austria Department of NeurologyMedical University InnsbruckInnsbruck 6020Austria
出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)
年 卷 期：2020年第26卷第47期
页 面：7584-7592页
核心收录：
学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学]
主 题：Enteropathy-associated T cell lymphoma Brain neoplasm Celiac disease Cerebellar syndrome Case report
摘 要：BACKGROUND Enteropathy-associated T cell lymphoma(EATL)is an aggressive intestinal T cell lymphoma derived from intraepithelial lymphocytes,which occurs in individuals with celiac disease(CD).Cerebral involvement is an extremely rare condition and as described so far,lymphoma lesions may present as parenchymal predominantly supratentorial or leptomeningeal *** describe a case of EATL with multifocal supra-and infratentorial brain involvement in a patient with refractory celiac disease(RCD).CASE SUMMARY A 58-years old man with known CD developed ulcerative jejunitis and was diagnosed with RCD type *** months later he presented with subacute cerebellar symptoms(gait ataxia,double vision,dizziness).Cranial magnetic resonance imaging(MRI)revealed multifocal T2 hyperintense supra-and infratentorial *** studies of blood and cerebrospinal fluid were inconspicuous for infectious,inflammatory or autoimmune diseases.18Ffluorodeoxyglucose-positron emission tomography/computed tomography(18FDG-PET/CT)scan showed a suspect hypermetabolic lesion in the left upper abdomen and consequent surgical jejunal resection revealed the diagnosis of *** the diagnostic work-up,neurological symptoms aggravated and evolved refractory to high-dosage *** MRI scans showed progressive cerebral lesions,highly suspicious for lymphoma and methotrexate chemotherapy was ***,clinically the patient responded only ***,cerebral biopsy confirmed the diagnosis of cerebral involvement of *** the poor prognosis and deterioration of the performance status,best supportive care was *** patient passed away three weeks after *** EATL with cerebral involvement must be considered as a possible differential diagnosis in patients with known RCD presenting with neurological symptoms.
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