Granulocytic sarcoma mimicking HSV encephalitis

Reena S. Shah, Robert K. Shin, Rudy J. Castellani

Research output: Contribution to journalArticlepeer-review

7 Scopus citations

Abstract

Introduction: Granulocytic sarcomas, or chloromas, are extramedullary collections of immature granulocytes. Central nervous system involvement is rare and of those cases described, most are complications of acute myelogenous leukemia. Case Report: A 40-year-old man with chronic myelogenous leukemia presented with seizure and encephalopathy. Magnetic resonance imaging of the brain revealed temporal T2 hyperintensities with gyriform cortical enhancement. Cerebrospinal fluid showed mild pleocytosis and elevated protein. Electroencephalography demonstrated periodic lateralized epileptiform discharges. Acyclovir was initiated for herpes simplex encephalitis, however, follow-up MRI showed extension of the lesion. MR spectroscopy suggested tumor, confirmed by brain biopsy. Postradiation MRI showed a significant decrease in lesion size. Conclusion: Granulocytic sarcoma can present as intraparenchymal cerebral lesions in patients with chronic myelogenous leukemia and may mimic herpes simplex encephalitis.

Original languageEnglish (US)
Pages (from-to)319-321
Number of pages3
JournalNeurologist
Volume16
Issue number5
DOIs
StatePublished - Sep 2010
Externally publishedYes

Keywords

  • central nervous system
  • chronic leukemic infiltration
  • encephalitis
  • herpes simplex
  • myeloid
  • myeloid leukemia
  • sarcoma

ASJC Scopus subject areas

  • Clinical Neurology

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