An Autopsy Case of Bing-Neel Syndrome: Discrepancy between the Radiological and Pathological Findings

A 64-year-old man previously diagnosed with Waldenstrom's macroglobulinemia presented to our hospital with confusion. Magnetic resonance imaging (MRI) revealed diffuse meningeal enhancement. The patient was diagnosed with Bing-Neel syndrome (BNS) based on an elevated IgM index and the presence...

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Detalles Bibliográficos
Autores principales: Matsuda, Sakino, Sekiguchi, Naohiro, Ito, Kenichi, Takaoka, Ken, Furuki, Misako, Hirano, Kazuhiko, Obayashi, Masato
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Japanese Society of Internal Medicine 2019
Materias:
Case Report
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6663539/
https://www.ncbi.nlm.nih.gov/pubmed/30918173
http://dx.doi.org/10.2169/internalmedicine.1907-18
Descripción
Sumario:A 64-year-old man previously diagnosed with Waldenstrom's macroglobulinemia presented to our hospital with confusion. Magnetic resonance imaging (MRI) revealed diffuse meningeal enhancement. The patient was diagnosed with Bing-Neel syndrome (BNS) based on an elevated IgM index and the presence of monoclonal IgM protein, as detected by immunofixation electrophoresis of the cerebrospinal fluid. The patient underwent intrathecal and systemic chemotherapy but ultimately died of pneumonia. An autopsy revealed extensive meningeal and perivascular infiltration by malignant cells throughout the brain and spine. Thus, BNS may cause more extensive malignant infiltration into the central nervous system than is revealed by MRI.

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