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JAMA Oncology Clinical Challenge
May 28, 2020

Brain Lesion in the Setting of Chronic Rituximab Treatment

Author Affiliations
  • 1Radiology and Radiological Science, Medical University of South Carolina, Charleston
JAMA Oncol. 2020;6(7):1093-1094. doi:10.1001/jamaoncol.2020.0160

A 75-year old woman with a history of follicular lymphoma and breast cancer presented with a 3-month history of gradual vision loss and 1-month history of confusion and difficulty with word finding. She had been diagnosed with hormone receptor–positive right breast cancer 8 years prior and underwent lumpectomy and treatment with an aromatase inhibitor, with remission since. Five years later, she subsequently developed left inguinal adenopathy, which biopsy results showed was follicular lymphoma. At that time, she was treated with a course of bendamustine and rituximab with subsequent maintenance treatment with rituximab for 2 years. Magnetic resonance imaging (MRI) of the brain was performed, demonstrating T2 fluid-attenuated inversion recovery hyperintensity in the left occipital and temporal lobes, crossing the corpus callosum and extending into the right occipital lobe without enhancement (Figure).

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