視野障害を初発とした脳内angiotropic lymphoma

Visual field defect as the initial amanifestation in a case of intracranial angiotropic lymphoma

　視野障害を初発とし，多彩な中枢神経症状をきたした極めて稀なangiotropic lymphomaの症例を経験したので報告した。48歳の男性で，視力は正常で，右下1／4同名半盲を呈した。神経学的症候として，純粋失読，相貌失認，構語障害がみられた。脳のMRIでは，T1強調画像にて高信号を示す領域が後頭葉皮質と脳梁膨大部に描出された。脳生検による病理組織学的検索を行い，angiotropiclymphomaと診断された。多剤併用化学療法（doxorubicin hydrochioride・cyclophosphamide・vincristinesulfate・etoposide）を6クール施行し，症状は寛解した。

A 48-year-old male presented with bilateral right inferior homonymous quadrantanopia since 3 months before. The visual acuity was normal. He had alexia, prosopagnosia and alalia. Magnetic resonance imaging (MRI) showed high intensity areas in the left occipital cortex and splenium of the corpus callosum. Biopsy of the intracranial lesion showed, immunohistochemically, angiotropic lymphoma. Complete remission was obtained after six courses of chemotherapy with doxorubicin, cyclophosphamide, vincristine and etoposide.