Intravascular lymphomatosis of the brain: a diagnostic problem

Intravascular lymphomatosis (of B- or T-cell origin) is a rare lymphoprolif erative disorder characterised by neoplastic proliferation of lymphoid cell s within the lumen of capillaries, small veins and arteries with no or mini mal involvement of the parenchyma. Its predilection sites are the skin and the brain. We studied a 44-year-old man who presented with a 2 year history of unexplained LDH elevation followed by a neurological syndrome without s ystemic involvement. Brain biopsy showed an intravascular lymphoma of the B -cell lineage. This report illustrates the diagnostic challenge of this rar e disorder with a grim prognosis. (C) 1999 Elsevier Science B.V. All rights reserved.