Intravascular lymphoma and Acute Haemorrhagic Leucoencephalitis are rapidly progressive diseases with poor prognosis. Differentiated between CNS variant of IVL and AHLE can be challenging, as they both can be clinically identical. Our case is about 63-year-old female, who presented with rapid onset of cognitive impairment. During her hospitalization, another rapid deterioration has occurred, and she became tetraplegic, with aphasia, and obtunded. Brain MRI showed many confluent lesions in the white matter, with. Most lesions appeared hemorrhagic. After the MRI, a radiological and clinical differential diagnosis between intravascular lymphoma and Acute Haemorrhagic Leucoencephalitis was made. Rapid brain biopsy has revealed the diagnosis of IVL. She had a good responsive to therapy, and regained most of her cognitive and motor functions.
Jonathan Naftali*, Gilad Itchaki, Maor Mermelstein and Felix Benninger