Acute disseminated encephalomyelitis mimicking brain lymphoma

Abstract EN

We report here on a 10-years-old female patient, previously healthy, presented with a short history of neurological symptoms, among which ataxic gait, headache, recurrent falling down and inability to move left leg were found.

Initial diagnosis was brain lymphoma depending on the brain MRI findings.

CT scan of the chest, abdomen, and pelvis were normal.

Bone marrow biopsy showed no bone marrow involvement by lymphoma or leukemia.

Brain biopsy was performed and showed evidence of demyelination but no evidence of malignancy.

Acute disseminated encephalomyelitis became a very likely diagnosis on the basis of the clinical, brain MRI and biopsy findings.

The patient was started on methylprednisolone pulse therapy for five days after which she gradually improved regarding her gait and neurological status and general well being.

A follow up brain MRI revealed significant improvement.

She was followed up and she was back to normal over four weeks duration.

We conclude that acute disseminated encephalomyelitis may present as lymphoma and should be considered in the differential diagnosis.