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Journal of Korean Neurosurgical Society 2009;46(6): 588-591.
doi: https://doi.org/10.3340/jkns.2009.46.6.588
Brain Magnetic Resolution Imaging to Diagnose Bing-Neel Syndrome.
Ho Jung Kim, Sang il Suh, Joo Han Kim, Byung Jo Kim
1Department of Neurology, Korea University College of Medicine, Seoul, Korea. nukbj@korea.ac.kr
2Department of Radiology, Korea University College of Medicine, Seoul, Korea.
3Department of Neurosurgery, Korea University College of Medicine, Seoul, Korea.
ABSTRACT
Radiologic findings of Bing-Neel syndrome, which is an extremely uncommon complication resulting from malignant lymphocyte infiltration into the central nervous system (CNS) in patients with Waldenstrom's macroglobulinemia (WM), have been infrequently reported due to extreme rarity of the case. A 75-year-old man with WM presented at a neurology clinic with progressive gait and memory disturbances, and dysarthria of 2 months duration. Cerebrospinal fluid and serum protein electrophoresis and immunofixation electrophoresis showed IgM kappa-type monoclonal gammopathy. Brain magnetic resonance imaging revealed multifocal, hyperintense lesions on T2 weighted-images. Brain diffusion-weighted imaging (DWI) demonstrated hyperintensities in cerebral and cerebellar lesions that appeared isointense on apparent diffusion coefficient maps, which were compatible with vasogenic edema. Although histologic analysis is a confirmative study to prove direct cell infiltration into the brain, brain MRI with DWI may be a good supportive study to diagnose Bing-Neel syndrome.
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