Granulomatous angiitis masquerading as a mass lesion. Magnetic resonance imaging and stereotactic biopsy findings in a patient with occult Hodgkin's disease

Surg Neurol. 1989 Jan;31(1):49-53. doi: 10.1016/0090-3019(89)90217-6.


Granulomatous angiitis is a frequently fatal central nervous system vasculitis of unknown pathogenesis sporadically associated with Hodgkin's disease, mixed cellularity type. We describe a 58-year-old woman presenting with headaches, progressive spastic paraparesis, equivocal computed tomography findings, and magnetic resonance imaging findings of increased signal intensity biparietally on T2-weighted imaging in a relatively discrete pattern. Magnetic resonance imaging-directed serial stereotactic biopsies revealed granulomatous angiitis throughout the right parieto-occipital region and splenium. Simultaneous biopsy of an enlarged submandibular mass revealed Hodgkin's disease, lymphocyte-predominant type. This case shows that granulomatous angiitis may be associated with magnetic resonance imaging findings suggesting a mass lesion in lymphocyte-predominant as well as mixed cellularity Hodgkin's disease.

Publication types

  • Case Reports

MeSH terms

  • Brain / pathology*
  • Diagnosis, Differential
  • Female
  • Granuloma / etiology
  • Granuloma / pathology*
  • Hodgkin Disease / complications
  • Hodgkin Disease / pathology*
  • Humans
  • Magnetic Resonance Imaging
  • Middle Aged
  • Neurologic Examination
  • Postoperative Period
  • Stereotaxic Techniques
  • Vasculitis / etiology
  • Vasculitis / pathology*