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American Journal of Neuroradiology 26:642-645, March 2005
© 2005 American Society of Neuroradiology

Case Report
BRAIN

Lymphocytic Vasculitis Mimicking Aggressive Multifocal Cerebral Neoplasm: MR Imaging and MR Spectroscopic Appearance

Neeraj J. Panchala, Soheil Nikua and Steven G. Imbesia

a From the Department of Radiology, University of California, San Diego Medical Center, San Diego, CA

Address correspondence to Steven G. Imbesi, Department of Radiology, University of California, San Diego Medical Center, 200 West Arbor Drive, Mail Code #8756, San Diego, CA 92103

Summary: We present a case of multifocal enhancing lesions confined to the right cerebral hemisphere that mimicked diffuse neoplasm. MR spectroscopy revealed not only minimal elevation of the choline peak, but also marked elevation of the glutamate and glutamine peaks, findings that are more suggestive of an inflammatory process. Biopsy showed lymphocytic vasculitis, a rare variant of primary angiitis of the CNS. Following appropriate medical therapy, MR imaging demonstrated complete resolution of the lesions.






Copyright © 2010 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X