Chronic Graft-versus-host Disease Presenting with Multiple Punctate Intracranial Lesions on Contrast-enhanced Magnetic Resonance Imaging Chronic Graft-versus-host Disease Presenting with Multiple Punctate Intracranial Lesions on Contrast-enhanced Magnetic Resonance Imaging

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Author(s)

    • Terada Makoto
    • Department of Neurology, Faculty of Medicine, University of Tsukuba, Japan
    • Obara Naoshi
    • Department of Hematology, Faculty of Medicine, University of Tsukuba, Japan
    • Ogawa Shinichi
    • Department of Hematology, Faculty of Medicine, University of Tsukuba, Japan
    • Sakamoto Noriaki
    • Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Japan
    • Sato Taiki
    • Department of Diagnostic Pathology, Faculty of Medicine, University of Tsukuba, Japan
    • Nohara Seitaro
    • Department of Neurology, Faculty of Medicine, University of Tsukuba, Japan
    • Chiba Shigeru
    • Department of Hematology, Faculty of Medicine, University of Tsukuba, Japan
    • Tamaoka Akira
    • Department of Neurology, Faculty of Medicine, University of Tsukuba, Japan

Abstract

<p>Central nervous system graft-versus-host disease can present quite a diagnostic challenge. We herein present a case of histologically-confirmed chronic graft versus host disease (GVHD) involving the central nervous system that occurred at 19 months after peripheral blood stem cell transplantation. Cranial magnetic resonance imaging showed areas of confluent hyperintensity in the deep/subcortical white matter with multiple punctate and curvilinear gadolinium enhancements, suggesting the disruption of the blood-brain barrier. A brain biopsy revealed perivascular CD3-positive T cell infiltration around the small vessels. We propose that the detection of punctate-enhanced lesions by magnetic resonance imaging may be a useful finding that facilitates the early diagnosis of chronic GVHD involving the central nervous system. </p>

Journal

  • Internal Medicine

    Internal Medicine 56(3), 363-368, 2017

    Japanese Society of Internal Medicine

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