Intravascular Lymphoma as a Cause of Recurrent Strokes - Case Report and Review of the Literature.
Case report
Cryptogenic stroke
Intravascular lymphoma
Neurocritical care
Stroke
Journal
The Neurohospitalist
ISSN: 1941-8744
Titre abrégé: Neurohospitalist
Pays: United States
ID NLM: 101558199
Informations de publication
Date de publication:
Oct 2023
Oct 2023
Historique:
pmc-release:
01
10
2024
medline:
13
9
2023
pubmed:
13
9
2023
entrez:
13
9
2023
Statut:
ppublish
Résumé
Intravascular lymphoma is an uncommon cause of ischemic strokes. Because of its rarity and atypical pattern, most diagnoses are made post-mortem. We present a case of a 68-year-old male with multiple cardiovascular risk factors and recent SARS-CoV-2 infection who presented with recurrent strokes. Because of his stroke risk factors, he was initially managed with a sequentially escalating antithrombotic regimen. A malignant process was low on the differential at this point given his lack of systemic symptoms. When he continued to have new strokes despite these measures, including a spinal cord infarct, a broad workup was sent including for hypercoagulable states, vasculitis, and intravascular lymphoma. Eventually, a skin biopsy of a cherry angioma returned positive for lymphoma cells. He was treated with methotrexate followed by chemotherapy and rituximab. Unfortunately, he did not improve and was made comfort measures only by his family. This case illustrates the importance of considering intravascular lymphoma as a potential etiology of recurrent strokes, as early diagnosis and treatment are important for preventing irreversible neurological damage.
Sections du résumé
Background
UNASSIGNED
Intravascular lymphoma is an uncommon cause of ischemic strokes. Because of its rarity and atypical pattern, most diagnoses are made post-mortem.
Case study
UNASSIGNED
We present a case of a 68-year-old male with multiple cardiovascular risk factors and recent SARS-CoV-2 infection who presented with recurrent strokes. Because of his stroke risk factors, he was initially managed with a sequentially escalating antithrombotic regimen. A malignant process was low on the differential at this point given his lack of systemic symptoms. When he continued to have new strokes despite these measures, including a spinal cord infarct, a broad workup was sent including for hypercoagulable states, vasculitis, and intravascular lymphoma. Eventually, a skin biopsy of a cherry angioma returned positive for lymphoma cells. He was treated with methotrexate followed by chemotherapy and rituximab. Unfortunately, he did not improve and was made comfort measures only by his family.
Conclusion
UNASSIGNED
This case illustrates the importance of considering intravascular lymphoma as a potential etiology of recurrent strokes, as early diagnosis and treatment are important for preventing irreversible neurological damage.
Identifiants
pubmed: 37701250
doi: 10.1177/19418744231183483
pii: 10.1177_19418744231183483
pmc: PMC10494820
doi:
Types de publication
Case Reports
Langues
eng
Pagination
419-424Informations de copyright
© The Author(s) 2023.
Déclaration de conflit d'intérêts
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
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