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Images in Neurology
June 2006

Atypical Appearance of a Primary Central Nervous System Lymphoma

Arch Neurol. 2006;63(6):908-909. doi:10.1001/archneur.63.6.908

A 37-year-old female cachectic, immunocompetent, human immunodeficiency virus–negative patient (weight, 39 kg) presented with a slowly progressive paraparesis and a mild fluctuating psychotic pathology developing over half a year. Because of a limited spectrum of food intake that mainly consisted of falafel (containing Lathyrus sativus), neurolathyrism was suspected during a previous hospitalization. However, incommensurate with that diagnosis, a cerebral magnetic resonance imaging scan (Figure, A-C) showed an uncommon, remarkable, multifocal, streaklike contrast enhancement that appeared to follow the perivascular spaces. A spinal magnetic resonance imaging scan displayed a myelopathy with swelling of the whole spinal cord.

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