LYMPHOMATOID GRANULOMATOSIS INVOLVING THE CENTRAL NERVOUS-SYSTEM - RADIOLOGIC-PATHOLOGIC CORRELATION

When the patient was readmitted with her first signs of neurologic symptoms, a radionuclide brain scan showed abnormal uptake in both temporal lobes and right parietal lobe. Computed tomography (CT) showed slight ventricular enlargement. After intravenous injection of contrast material, three lesions were defined on CT that had nonhomogeneous reduced density with central contrast enhancement. On her final admission before dying, repeat CT showed progression of the previously described lesions, as well as an additional mass in the cerebellar vermis. Repeat radionuclide scan had abnormal uptake in both temporal lobes, right parietal lobe, and cerebellar vermis. Cerebral angiography confirmed the presence of an avascular mass in the cerebellar vermis. Sylvian segments of both middle cerebral arteries showed caliber variations: focal constriction adjacent to aneurysmal dilatation. Angiographic findings were interpreted as necrotizing vasculitis.