Tumor-like Presentation of Cerebral Vasculitis in a Patient With Systemic Lupus Erythematosus: A Biopsy-confirmed Case

다국어 초록 (Multilingual Abstract)

Central nervous system (CNS) manifestations of systemic lupus erythematosus (SLE) are diverse and often difficult to distinguish from SLE-unrelated events. CNS vasculitis is a rare manifestation, which is seen in less than 10% of post-mortem studies, and lesions with multifocal cerebral cortical microinfarcts associated with small-vessel vasculitis are the predominant feature. However, CNS vasculitis presenting as a tumor-like mass lesion in SLE has rarely been reported. Herein, we report a case of cerebral vasculitis mimicking a brain tumor in a 39-year-old female with SLE. A biopsy of the brain mass revealed fibrinoid necrosis and leukocytoclastic vasculitis. The neurological deficits and systemic symptoms improved after treatment with corticosteroids and immunosuppressive agents. To the best of our knowledge, there are no reports of biopsy-proven cerebral vasculitis presenting as a brain mass in patients with SLE in Korea.

참고문헌 (Reference)

1 Barile-Fabris L, "Vasculitis in systemic lupus erythematosus" 16 : 440-, 2014

2 Huang CH, "Tumor-like cerebral perivasculitis in a pediatric patient with systemic lupus erythematosus" 24 : 218-222, 2008

3 Ruiz-Irastorza G, "Treating systemic lupus erythematosus in the 21st century : new drugs and new perspectives on old drugs" 59 (59): v69-v81, 2020

4 Ahn GY, "Prevalence, risk factors, and impact on mortality of neuropsychiatric lupus: a prospective, single-center study" 27 : 1338-1347, 2018

5 Bertsias GK, "Pathogenesis, diagnosis and management of neuropsychiatric SLE manifestations" 6 : 358-367, 2010

6 Schwartz N, "Neuropsychiatric lupus : new mechanistic insights and future treatment directions" 15 : 137-152, 2019

7 Carrión-Barberà I, "Neuropsychiatric involvement in systemic lupus erythematosus : a review" 20 : 102780-, 2021

8 Smits M, "Imaging of oligodendroglioma" 89 : 20150857-, 2016

9 Kleinig TJ, "Fulminant leucocytoclastic brainstem vasculitis in a patient with otherwise indolent systemic lupus erythematosus" 18 : 486-490, 2009

10 Rowshani AT, "Cerebral vasculitis as a primary manifestation of systemic lupus erythematosus" 64 : 784-786, 2005

11 Küker W, "Cerebral vasculitis : imaging signs revisited" 49 : 471-479, 2007

12 Rodrigues M, "Central nervous system vasculitis in systemic lupus erythematosus : a case series report in a tertiary referral centre" 26 : 1440-1447, 2017

13 Abraham P, "Central nervous system systemic lupus erythematosus (CNS-SLE) vasculitis mimicking Lewy body dementia: a case report emphasizing the role of imaging with an analysis of 33 comparable cases from the scientific literature" 34 : 128-141, 2021

14 Ellis SG, "Central nervous system involvement in systemic lupus erythematosus: a review of neuropathologic findings in 57cases, 1955--1977" 8 : 212-221, 1979

15 Hanly JG, "Brain pathology in systemic lupus erythematosus" 19 : 732-741, 1992