Bilaterales hippocampales primäres ZNS-Lymphom: ungewöhnliche Differentialdiagnose eines rasch progredienten dementiellen Syndroms

Zusammenfassung

Vorgestellt wird ein rasch progredientes dementielles Syndrom bei einem 63-Jährigen infolge eines bilateralen hippocampalen primären ZNS-Lymphoms. Da es sich bei sekundären Demenzformen um potentiell kausal behandelbare Ätiologien handelt, kommt der schnellen Diagnosestellung eine entscheidende Bedeutung zu. Die richtungweisenden bildgebenden Aspekte insbesondere bei hippocampalen Prozessen werden diskutiert.

Abstract

We report on a 63-year old man suffering from rapid progressive dementia due to bilateral hippocampal primary CNS lymphoma. Early diagnosis especially in secondary dementia is essential because of potentially treatable aetiologies with regression of cognitive and behaviour abnormalities. Characteristic imaging findings especially in inflammatory and neoplastic lesions affecting the hippocampal structures are discussed.

Schlüsselwörter

ZNS-Lymphom - primär - Demenz - Hippocampus - MRT

Key words

CNS-lymphoma - primary - dementia - hippocampus - MRI

• Literatur

• 1 Frisoni GB, Fox NC, Jack CR. et al. The clinical use of structural MRI in Alzheimer disease. Nat Rev Neurol 2010; 6: 67-77
• 2 Zerr I, Stoeck K, Schmidt C. et al. Rasch progressive Demenzen. Akt Neurol 2012; 39: 138-144
• 3 Vitali P, Migliaccio R, Agosta F. et al. Neuroimaging in dementia. Semin Neurol 2008; 28: 467-483
• 4 Leypoldt F. Autoimmune Enzephalitiden. Fortschr Neurol Psychiatr 2013; 81: 523-538
• 5 Flanagan EP, McKeon A, Lennon VA. et al. Autoimmune Dementia: Clinical Course and Predictors of Immunotherapy Response. Mayo Clin Proc 2010; 85: 881-897
• 6 Granerod J, Ambrose HE, Davies NWS. et al. Causes of encephalitis and differences in their clinical presentations in England: a multicenter, population-based prospective study. Lancet Infect Dis 2010; 10: 835-44
• 7 Bulakbasi N, Kocaoglu M. Central Nervous System Infections of the Herpesvirus Family. Neuroimag Clin N Am 2008; 18: 53-83
• 8 Demaerel P, van Dessel W, van Paesschen W. et al. Autoimmune-mediated encephalitis. Neuroradiology 2011; 53: 837-851
• 9 Albrecht R, Krebs B, Reusche E. et al. Signs of rapidly progressive dementia in a case of intravascular lymphomatosis. Eur Arch Psychiatry Clin Neurosci 2005; 232: 232-235
• 10 Haldorson IS, Espeland A, Larsson EM. Central Nervous System Lymphoma: Characteristic Findings on Traditional and Advanced Imaging. AJNR Am J Neuroradiol 2011; 32: 984-992
• 11 Nagappa M, Sinha S, Taly AB. et al. Neurosyphilis: MRI features and their phenotypic correlation in a cohort of 35 patients from a tertiary care university hospital. Neuroradiology 2013; 55: 379-388
• 12 Capizzano AA, Kirby P, Moritani P. Limbic Tumors of the Temporal Lobe: Radiologic-Pathologic Correlation. Clin Neuroradiol 2015; 25: 127-135
• 13 Louis DN, Perry A, Reifenberger G. et al. The 2016 World Health Organization Classification of Tumors of the Central Nervous System. A Summary. Acta Neuropathol 2016; 131: 803-820
• 14 Korfel A, Schlegel U. Primäre ZNS-Lymphome–Fortschritte in der Diagnostik und Therapie. Nervenarzt 2015; 86: 710-715