A tumefactive anti-MOG antibody associated disorder heralding central nervous system B-cell lymphoma: Case report on diagnostic challenge

• Published in: Journal of neuroimmunology Vol. 365; p. 577823
• Main Authors: Uzura, Yasunori, Takeuchi, Hayato, Ashida, Shinji, Fujii, Chihiro, Shishido-Hara, Yukiko, Inaba, Tohru, Takai, Yoshiki, Akazawa, Kentaro, Mizuno, Toshiki, Hashimoto, Naoya
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 15.04.2022
• Subjects: Anti-myelin oligodendrocyte glycoprotein antibody associated disorders; Autoantibodies; Central Nervous System; Female; Flow cytometry; Humans; Lymphoma, B-Cell - diagnosis; Lymphoma, B-Cell - diagnostic imaging; Magnetic Resonance Imaging; Middle Aged; Myelin-Oligodendrocyte Glycoprotein; Primary central nervous system lymphoma; Regional cerebral blood flow; Flow cytometry; Primary central nervous system lymphoma; Anti-myelin oligodendrocyte glycoprotein antibody associated disorders; Regional cerebral blood flow
• ISSN: 0165-5728; 1872-8421
• DOI: 10.1016/j.jneuroim.2022.577823

We present the case of a 52-year-old woman with right hemiparesis due to a mass lesion in the left parietal white matter and corpus callosum. The lesion was hyperintense on diffusion weighted image and homogenously enhanced with gadolinium on magnetic resonance imaging, and was radiologically indistinguishable with lymphoma. Following progressive aggravation of symptoms, craniotomy for biopsy of the lesion was performed, and it was revealed that the patient had anti-myelin oligodendrocyte glycoprotein-associated disease by histopathological and serological diagnosis. Initial treatment with steroid dramatically improved the symptoms, but they exacerbated again. Then, through cerebrospinal fluid examination, it was revealed that the patient had B-cell lymphoma. [Display omitted]