When Zoster Virus Hides a Primary Brain Lymphoma
Autor(a) principal: | |
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Data de Publicação: | 2019 |
Outros Autores: | , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://hdl.handle.net/10400.26/33938 |
Resumo: | To describe an unusual presentation of a primary lymphoma of the central nervous system in a patient who, four months prior to admission, was diagnosed with herpes zoster ophthalmicus (HZO). Case description: A 68-year-old man, with a history of HZO, was admitted to the emergency department with nausea and vomiting that had persisted over the previous two weeks. Neurological evaluation showed right ptosis, divergent strabismus and anisocoria. Blood tests showed high c-reactive protein, while serology was negative for human immunodeficiency virus. A brain CT scan revealed three round lesions, slightly hyperdense, periventricular in the occipital and frontal regions, which biopsy revealed to be a diffuse large B-cell lymphoma. The patient started chemotherapy but progression to death was inevitable. Conclusion: The authors describe an unusual presentation of primary lymphoma of the central nervous system and urge physicians to be aware of this presentation in order to avoid misdiagnosis. |
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When Zoster Virus Hides a Primary Brain LymphomaImmunocompetent, lymphomacentral nervous system,Zoster virus;Madeira IslandTo describe an unusual presentation of a primary lymphoma of the central nervous system in a patient who, four months prior to admission, was diagnosed with herpes zoster ophthalmicus (HZO). Case description: A 68-year-old man, with a history of HZO, was admitted to the emergency department with nausea and vomiting that had persisted over the previous two weeks. Neurological evaluation showed right ptosis, divergent strabismus and anisocoria. Blood tests showed high c-reactive protein, while serology was negative for human immunodeficiency virus. A brain CT scan revealed three round lesions, slightly hyperdense, periventricular in the occipital and frontal regions, which biopsy revealed to be a diffuse large B-cell lymphoma. The patient started chemotherapy but progression to death was inevitable. Conclusion: The authors describe an unusual presentation of primary lymphoma of the central nervous system and urge physicians to be aware of this presentation in order to avoid misdiagnosis.CASE DESCRIPTION A 68-year-old Caucasian male was asymptomatic until two weeks before admission to the emergency department, when he developed nausea and vomiting, which persisted despite antiemetic medication. Other than a diagnosis of right-sided herpes zoster ophthalmicus (HZO), four months before admission, and type 2 diabetes, his past medical history was unremarkable. General examination on admission was normal but neurological examination revealed right ptosis, divergent strabismus and anisocoria. Blood tests revealed normocytic normochromia anaemia with Hb 10.2, VGM 86 fl, leucocytes 5,100×109/l, thrombocytopenia with a platelet count of 91,000×109/l and a C-reactive protein level of 61.5 mg/l (normal <3 mg/l). A CT scan of the brain to rule out stroke surprisingly showed three round lesions, slightly hyperdense, with intra-axial and periventricular location (Fig.1). Cerebrospinal fluid collected by lumbar puncture was acellular with normal protein and glucose levels, ruling out a CNS infection. Autoimmune study and serological tests, including tests for human immunodeficiency virus (HIV), hepatitis virus, syphilis and Epstein-Barr virus, were negative.EFIM- Official Journal of Internal MedicineRepositório ComumNascimento, Rafael FerreiraFreitas, João MiguelBrazão, Maria Da Luz2020-11-06T13:00:45Z20192019-01-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10400.26/33938engFerreira Nascimento R, Freitas JM, Luz Brazão M. When Zoster virus hides a primary brain lymphoma. EJCRIM 2019;6:2284-259410.12890/2019_001341info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-11-10T02:17:04Zoai:comum.rcaap.pt:10400.26/33938Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T22:34:29.176420Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
When Zoster Virus Hides a Primary Brain Lymphoma |
title |
When Zoster Virus Hides a Primary Brain Lymphoma |
spellingShingle |
When Zoster Virus Hides a Primary Brain Lymphoma Nascimento, Rafael Ferreira Immunocompetent, lymphoma central nervous system, Zoster virus ;Madeira Island |
title_short |
When Zoster Virus Hides a Primary Brain Lymphoma |
title_full |
When Zoster Virus Hides a Primary Brain Lymphoma |
title_fullStr |
When Zoster Virus Hides a Primary Brain Lymphoma |
title_full_unstemmed |
When Zoster Virus Hides a Primary Brain Lymphoma |
title_sort |
When Zoster Virus Hides a Primary Brain Lymphoma |
author |
Nascimento, Rafael Ferreira |
author_facet |
Nascimento, Rafael Ferreira Freitas, João Miguel Brazão, Maria Da Luz |
author_role |
author |
author2 |
Freitas, João Miguel Brazão, Maria Da Luz |
author2_role |
author author |
dc.contributor.none.fl_str_mv |
Repositório Comum |
dc.contributor.author.fl_str_mv |
Nascimento, Rafael Ferreira Freitas, João Miguel Brazão, Maria Da Luz |
dc.subject.por.fl_str_mv |
Immunocompetent, lymphoma central nervous system, Zoster virus ;Madeira Island |
topic |
Immunocompetent, lymphoma central nervous system, Zoster virus ;Madeira Island |
description |
To describe an unusual presentation of a primary lymphoma of the central nervous system in a patient who, four months prior to admission, was diagnosed with herpes zoster ophthalmicus (HZO). Case description: A 68-year-old man, with a history of HZO, was admitted to the emergency department with nausea and vomiting that had persisted over the previous two weeks. Neurological evaluation showed right ptosis, divergent strabismus and anisocoria. Blood tests showed high c-reactive protein, while serology was negative for human immunodeficiency virus. A brain CT scan revealed three round lesions, slightly hyperdense, periventricular in the occipital and frontal regions, which biopsy revealed to be a diffuse large B-cell lymphoma. The patient started chemotherapy but progression to death was inevitable. Conclusion: The authors describe an unusual presentation of primary lymphoma of the central nervous system and urge physicians to be aware of this presentation in order to avoid misdiagnosis. |
publishDate |
2019 |
dc.date.none.fl_str_mv |
2019 2019-01-01T00:00:00Z 2020-11-06T13:00:45Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/10400.26/33938 |
url |
http://hdl.handle.net/10400.26/33938 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
Ferreira Nascimento R, Freitas JM, Luz Brazão M. When Zoster virus hides a primary brain lymphoma. EJCRIM 2019;6: 2284-2594 10.12890/2019_001341 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
EFIM- Official Journal of Internal Medicine |
publisher.none.fl_str_mv |
EFIM- Official Journal of Internal Medicine |
dc.source.none.fl_str_mv |
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
instname_str |
Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
instacron_str |
RCAAP |
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RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
repository.name.fl_str_mv |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
repository.mail.fl_str_mv |
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1799134907067269121 |