J Korean Neurosurg Soc.  2009 Dec;46(6):588-591. 10.3340/jkns.2009.46.6.588.

Brain Magnetic Resolution Imaging to Diagnose Bing-Neel Syndrome

• Kim HJ
• Suh SI
• Kim JH
• Kim BJ

• KMID: 2190216
• DOI: http://doi.org/10.3340/jkns.2009.46.6.588

Abstract

Radiologic findings of Bing-Neel syndrome, which is an extremely uncommon complication resulting from malignant lymphocyte infiltration into the central nervous system (CNS) in patients with Waldenstrom's macroglobulinemia (WM), have been infrequently reported due to extreme rarity of the case. A 75-year-old man with WM presented at a neurology clinic with progressive gait and memory disturbances, and dysarthria of 2 months duration. Cerebrospinal fluid and serum protein electrophoresis and immunofixation electrophoresis showed IgM kappa-type monoclonal gammopathy. Brain magnetic resonance imaging revealed multifocal, hyperintense lesions on T2 weighted-images. Brain diffusion-weighted imaging (DWI) demonstrated hyperintensities in cerebral and cerebellar lesions that appeared isointense on apparent diffusion coefficient maps, which were compatible with vasogenic edema. Although histologic analysis is a confirmative study to prove direct cell infiltration into the brain, brain MRI with DWI may be a good supportive study to diagnose Bing-Neel syndrome.

Keyword

Bing-Neel syndrome; Waldenstrom's macroglobulinemia; MRI

MeSH Terms

Aged
Brain
Central Nervous System
Diffusion
Dysarthria
Edema
Electrophoresis
Gait
Humans
Immunoglobulin M
Lymphocytes
Magnetic Resonance Imaging
Magnetics
Magnets
Memory
Neurology
Paraproteinemias
Waldenstrom Macroglobulinemia
Immunoglobulin M