Abstract
A case of angiotropic B cell lymphoma wih multiple cerebral infarcts as the initial symptom is reported. A 48-year-old woman was admitted to our hospital with fever and weakness of the right lower limb in November 1993. Her level of consciousness rapidly decreased and left hemipa-resis also appeared. Brain CT and MRI showed multiple cerebral infarcts. Laboratory tests revealed thrombocytopenia, anemia, an increased serum LDH level, and fragmentation of red blood cells suggesting thrombotic thrombocytopenic purpura. Despite administration of corticosteroids and gly-cerin in combination with plasmapheresis, her symptoms did not improve.
In December 1993, a few abnormal cells appeared in the peripheral blood, and similar abnormal cells (4.4%) negative for both myeloperoxidase and non specific esterase staining were seen in the bone marrow. Lymphoid malignancy was suspected. She achieved complete remission after two courses of CHOP-E, but then relapsed. She subsequently received various chemotherapy regimens with only temporary improvement, and died of respiratory failure in October 1994. At autopsy, a diagnosis of angiotropic B cell lymphoma was made.
