Ischemic stroke as an initial presentation of primary bone marrow lymphoma
- Author:
Mi-Yeon Eun
;
June Woo Ahn
;
Dong Won Baek
;
Ji Yun Jeong
;
Jaechun Hwang
- Publication Type:Journal Article
- Keywords:
Bone Marrow Neoplasm;
Bone Marrow Examination;
Diffuse large B cell lymphoma;
Embolism and Thrombosis;
Stroke
- From:Neurology Asia
2020;25(1):59-62
- CountryMalaysia
- Language:English
-
Abstract:
Various cancer types have been associated with cancer-related cerebral infarction. In this study, we
describe the first case of cancer-related cerebral infarction in which the underlying disease was primary
bone marrow lymphoma (PBML). A 79-year-old man presented with abruptly developed bilateral lower
extremity weakness and confusion. Diffusion-weighted imaging on admission showed multiple cortical
and subcortical embolic infarction lesions in multiple vascular territories. Diagnostic evaluations to
determine the embolic source revealed no abnormalities. Laboratory testing demonstrated elevated
D-dimer (2.59 μg/mL) but no other prothrombotic abnormalities. In suspicion of cancer-related stroke,
we performed chest CT, abdomen CT, and FDG-PET to detect the hidden malignancy. Findings
revealed no evidence of cancer; however, they did reveal signs of anemia (hemoglobin 9.0 g/dL).
Bone marrow aspiration biopsy showed large atypical B cell involvement suggestive of high-grade B
cell lymphoma. The patient was diagnosed with primary bone marrow diffuse large B-cell lymphoma
initially presenting with ischemic stroke. Our case suggests that primary bone marrow cancer may be a
candidate for the differential diagnosis of hidden malignancy in patients with suspected cancer-related
stroke. Bone marrow biopsy may be essential for establishing an appropriate differential diagnosis in
patients with abnormal hematologic findings.
- Full text:7.2020my0009.pdf
