case_images: PMC3036638_01
case_images: Computed tomography scan of the brain (with contrast) showing ill-defined hypodensity lesion with multiple hypodensity spots at bilateral parieto-occipito-temporal regions. The lesion was more on the right than the left cerebral hemisphere.
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case_images: PMC3036638_01_1752-1947-5-24-1.jpg
case_images: F1
case_images: A computed tomography (CT) scan of the brain showed multiple hypodensity lesions at bilateral occipito-parieto-frontal and cerebellar regions consistent with cerebral infarction (Figure 1).
case_images: MRI scan of the brain demonstrating diffuse multi-stage intraparenchymal infarction and hemorrhage at both cerebral and cerebellar hemispheres, initially considered to be vasculitis.
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case_images: PMC3036638_01_1752-1947-5-24-2.jpg
case_images: F2
case_images: A magnetic resonance imaging (MRI) scan of the brain showed diffuse multistage intraparenchymal infarctions and hemorrhages in the bilateral cerebral and cerebellar hemispheres (Figure 2).
case_images: Magnetic resonance angiogram of the brain demonstrating normal patency of bilateral internal carotid arteries, anterior cerebral arteries, middle cerebral arteries, posterior cerebral arteries, and vertebrobasilar arteries.
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case_images: PMC3036638_01_1752-1947-5-24-3.jpg
case_images: F3
case_images: However, magnetic resonance angiography (MRA) of the brain revealed normal intracranial vasculature (Figure 3).
case_images: Skin biopsy. A) Low magnification showed no apparent diagnostic abnormality (hematoxylin and eosin stain, 40 x magnification). B) High magnification revealed a few large lymphoma cells in the lumens of capillaries in subcutaneous fat (hematoxylin and eosin stain, 400 x magnification). C) Large lymphoma cells marked with CD20. D) Scattered CD3+ small lymphocytes were noted among the large lymphoma cells. Copyright 2005 Blackwell Publishing Ltd. Reproduced with permission.
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case_images: PMC3036638_01_1752-1947-5-24-4.jpg
case_images: F4
case_images: Interestingly, the pathological findings of the random skin biopsies showed intravascular large B cell lymphoma (IVBL, positive for CD20) (Figure 4).