J Clin Neurol.  2007 Jun;3(2):108-111. 10.3988/jcn.2007.3.2.108.

Central Nervous System Lymphomatoid Granulomatosis Presenting with Parkinsonism

• Sohn EH
• Song CJ
• Lee HJ
• Kim S
• Kim JM
• Lee AY

• KMID: 1851023
• DOI: http://doi.org/10.3988/jcn.2007.3.2.108

Abstract

Lymphomatoid granulomatosis (LG) is a potentially malignant lymphoproliferative disorder. The lung is the most common involved site, followed by the skin and nervous system. However, LG of the central nervous system presenting with Parkinsonism is very rare. We report a patient with LG who presented with parkinsonian features such as bilateral rigidity, bradykinesia, and agitation. Brain magnetic resonance imaging showed multifocal punctuate enhanced lesions in both supra- and infratentorial areas. Steroid pulse therapy resulted in a dramatical improvement in the symptoms and MRI abnormalities.

Keyword

Lymphomatoid granulomatosis; Parkinsonism; Magnetic resonance imaging

MeSH Terms

Brain
Central Nervous System*
Dihydroergotamine
Humans
Hypokinesia
Lung
Lymphomatoid Granulomatosis*
Lymphoproliferative Disorders
Magnetic Resonance Imaging
Nervous System
Parkinsonian Disorders*
Skin
Dihydroergotamine

Figure

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  Figure 1 Brain MRI performed before treatment with steroid. T2-weighted MRI showed disseminated and multifocal hyperintense lesions in both basal ganglia, thalamus, cerebral cortex, and white matter (A, B), and disseminated multiple punctuate enhanced lesions in the corresponding areas of the T1-weighted images with gadolinium enhancement (C, D).

• 

  Figure 2 Brain MRI performed 2 months after treatment with steroid. Multiple punctuate disseminated lesions were completely resolved in T2-weighted (A, B) and gadoliniumenhanced T1-weighted (C, D) MRI images.

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