Intravascular Lymphomatosis Presenting with Cerebral Hemo

Background:Intravascular lymphomatosis (IL) usually produces vascular occlusion due to the angiotropic nature, which can result in infarct like lesions. Herein, we report a case of pathologically confirmed IL presenting with intracerebral hemorrhage (ICH). Case Report:A 53-year-old female was admitted for both legs weakness. Brain Magnetic resonance image (MRI) showed ICH on bilateral cerebral hemispheres. Spinal MRI showed lesion with patchy contrast enhancement. Cerebrospinal fluid (CSF) revealed an elevated red blood cell and white blood cell, with normal protein and glucose level. High dose glucocorticoid was given under the impression of vasculitis and the state of the patient showed transient improvement, but got worsened eventually. Chest computer tomography (CT) showed consolidation. Through lung biopsy, she was diagnosed with IL. Conclusion:This is a case of brain IL complicated by ICH not associated with coagulopathy. Increasing awareness of IL as a differential diagnosis may lead to more opportunities for treatment.