NeurovascularMedicine.com
The contents are under continuing development and improvements and may contain errors of omission or fact. This is not to be used for the assessment, diagnosis or management of patients. It should not be regarded as medical advice by healthcare workers or laypeople. It is for educational purposes only. Please adhere to your local protocols. If you are unwell please seek urgent healthcare advice. If you do not accept this then please do not use the website.

A

Malignant Intravascular Lymphomatosis


A very rare cause of stroke due to the proliferation of neoplastic cells of lymphoid origin within small blood vessels. Malignant cells bear the immunophenotype of B- or T-cell lineage. The affinity of tumour cells for capillary endothelium may be explained by lymphocyte receptors for endothelial membrane antigens [Baumann TP et al. 2000]. There is typically a progressive Dementia/Delirium developing over a few weeks with seizures and stroke like episodes

The clinical course is slowly progressive and it can be misdiagnosed as Limbic encephalitis, Herpes simplex encephalitis, CJD, Syphilis. There may be an increased LDH but blood and CSF may be free of lymphoma cells. May be an increase in CSF protein and Lymphocytes. EEG may show slowing. CT/MRI can be normal or show lesions. CT abdomen/pelvis for staging and looking for other disease.

Median survival of IML patients is only 6 months and there may be delayed diagnosis. May be reasonably to cover with aciclovir until diagnosis established. Once diagnosis confirmed then start Chemotherapy. e.g. CHOP


Note: The plan is to keep the website free through donations and advertisers that do not present any conflicts of interest. I am keen to advertise courses and conferences. If you have found the site useful or have any constructive comments please write to me at drokane (at) gmail.com. I keep a list of patrons to whom I am indebted who have contributed. If you would like to advertise a course or conference then please contact me directly for costs and to discuss a sponsored link from this site.

free web counter Hits