When Zoster Virus Hides a Primary Brain Lymphoma

Detalhes bibliográficos
Autor(a) principal: Nascimento, Rafael Ferreira
Data de Publicação: 2019
Outros Autores: Freitas, João Miguel, Brazão, Maria Da Luz
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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spelling 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
institution RCAAP
reponame_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
collection 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
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