Tuberc Respir Dis.  2012 Nov;73(5):273-277. 10.4046/trd.2012.73.5.273.

A Case of Paraneoplastic Limbic Encephalitis Associated with Small Cell Lung Cancer

• Ryu JY
• Lee SH
• Lee EJ
• Min KH
• Hur GY
• Lee SY
• Kim JH
• Lee SY
• Shin C
• Shim JJ
• In KH
• Kang KH
• Yoo SH

• KMID: 2050680
• DOI: http://doi.org/10.4046/trd.2012.73.5.273

Abstract

Paraneoplastic limbic encephalitis (PLE) is a rare syndrome characterized by memory impairment, affective and behavioral disturbances and seizures. Among many different neoplasms known to cause PLE, small cell lung cancer (SCLC) is the most frequently reported. The pathogenesis is not fully understood but is believed to be autoimmune-related. We experienced a patient with typical clinical features of PLE. A 67-year-old man presented with seizure and disorientation. Brain magnetic resonance imaging demonstrated high signal intensity in the bilateral amygdala and hippocampus in flair and T2-weighted images suggestive of limbic encephalitis. Cerebrospinal fluid tapping revealed no evidence of malignant cells or infection. Positron emission tomography/computed tomography showed a lung mass with pleural effusion and a consequent biopsy confirmed the diagnosis of PLE associated with SCLC. The patient was subsequently treated with chemotherapy and neurologic symptoms gradually improved.

Keyword

Limbic Encephalitis; Paraneoplastic Syndromes; Lung Neoplasms

MeSH Terms

Aged
Amygdala
Biopsy
Brain
Electrons
Hippocampus
Humans
Limbic Encephalitis
Lung
Lung Neoplasms
Magnetic Resonance Imaging
Memory
Neurologic Manifestations
Paraneoplastic Syndromes
Pleural Effusion
Seizures
Small Cell Lung Carcinoma

Figure

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  Figure 1 Brain magnetic resonance imaging showed high signal intensity on the flair (A) and T2-weighted image (B) in the bilateral amygdala and hippocampal area (arrows), compatible with limbic encephalitis.

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  Figure 2 Positron emission tomography/computed tomography showed hypermetabolism in the bilateral amygdala and hippocampal area and is more prominent at the right mediotemporal area (circle).

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