Multiple cerebral infarctions associated with lung cancer-induced hypereosinophilia: a case report.


Journal

BMC neurology
ISSN: 1471-2377
Titre abrégé: BMC Neurol
Pays: England
ID NLM: 100968555

Informations de publication

Date de publication:
13 Oct 2021
Historique:
received: 23 01 2021
accepted: 29 09 2021
entrez: 13 10 2021
pubmed: 14 10 2021
medline: 15 10 2021
Statut: epublish

Résumé

Hypereosinophilia (HE) is caused by various conditions, including solid and hematologic tumors. Nonetheless, there exist no reports on cerebral infarctions caused by HE associated with lung cancer metastasis to the bone marrow. We report a case of a 67-year-old man with multiple cerebral infarctions associated with HE. His white blood cell and eosinophil counts were 38,900/μL and 13,600/μL, respectively, at 4 weeks before admission. During treatment for HE, he presented with dysarthria and walking difficulties. Magnetic resonance imaging of the brain showed multiple small infarcts in regions such as the bilateral cortex, watershed area, and cerebellum. Chest computed tomography showed small nodes in the lung and enlargement of the left hilar lymph nodes. Bronchoscopic biopsy did not reveal a tumor; however, bone marrow biopsy showed infiltration of tumor cells. We considered a diagnosis of lung cancer metastasizing to the bone marrow, which induced HE and later caused cerebral infarctions. This case report demonstrates that metastatic cancer in the bone marrow can induce HE, which can consequently cause multiple cerebral infarctions. Clinicians should consider HE as a cause of multiple cerebral infarctions in patients with cancer.

Sections du résumé

BACKGROUND BACKGROUND
Hypereosinophilia (HE) is caused by various conditions, including solid and hematologic tumors. Nonetheless, there exist no reports on cerebral infarctions caused by HE associated with lung cancer metastasis to the bone marrow.
CASE PRESENTATION METHODS
We report a case of a 67-year-old man with multiple cerebral infarctions associated with HE. His white blood cell and eosinophil counts were 38,900/μL and 13,600/μL, respectively, at 4 weeks before admission. During treatment for HE, he presented with dysarthria and walking difficulties. Magnetic resonance imaging of the brain showed multiple small infarcts in regions such as the bilateral cortex, watershed area, and cerebellum. Chest computed tomography showed small nodes in the lung and enlargement of the left hilar lymph nodes. Bronchoscopic biopsy did not reveal a tumor; however, bone marrow biopsy showed infiltration of tumor cells. We considered a diagnosis of lung cancer metastasizing to the bone marrow, which induced HE and later caused cerebral infarctions.
CONCLUSIONS CONCLUSIONS
This case report demonstrates that metastatic cancer in the bone marrow can induce HE, which can consequently cause multiple cerebral infarctions. Clinicians should consider HE as a cause of multiple cerebral infarctions in patients with cancer.

Identifiants

pubmed: 34641815
doi: 10.1186/s12883-021-02423-1
pii: 10.1186/s12883-021-02423-1
pmc: PMC8513168
doi:

Types de publication

Case Reports Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

397

Subventions

Organisme : Ministry of Education, Culture, Sports, Science, and Technology of Japan
ID : KAKENHI No. 20K19453

Informations de copyright

© 2021. The Author(s).

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Auteurs

Maki Ozaki (M)

Department of Neurology, Nara Medical University School of Medicine Graduate School of Medicine, 840 Shijo-Cho, Kashihara, Nara, 634-8522, Japan.

Tomoo Mano (T)

Department of Neurology, Nara Medical University School of Medicine Graduate School of Medicine, 840 Shijo-Cho, Kashihara, Nara, 634-8522, Japan. manoneuro@naramed-u.ac.jp.

Nobuyuki Eura (N)

Department of Neurology, Nara Medical University School of Medicine Graduate School of Medicine, 840 Shijo-Cho, Kashihara, Nara, 634-8522, Japan.

Kazuhide Horimoto (K)

Second Department of Internal Medicine, Nara Medical University School of Medicine Graduate School of Medicine, 840 Shijo-Cho, Kashihara, Nara, 634-8522, Japan.

Masato Takano (M)

Department of Diagnostic Pathology, Nara Medical University School of Medicine Graduate School of Medicine, 840 Shijo-Cho, Kashihara, Nara, 634-8522, Japan.

Chiho Ohbayashi (C)

Department of Diagnostic Pathology, Nara Medical University School of Medicine Graduate School of Medicine, 840 Shijo-Cho, Kashihara, Nara, 634-8522, Japan.

Kazuma Sugie (K)

Department of Neurology, Nara Medical University School of Medicine Graduate School of Medicine, 840 Shijo-Cho, Kashihara, Nara, 634-8522, Japan.

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