Department of Pathology, University of Oklahoma Health Sciences Center

 

August 2004, Case 408-2. Quiz set! Click here to see.

A 55 year-old woman with granulomatous dermititis and cerebral masses

Clinical informationThe patient was a 55-yo woman with a history of myasthenia gravis and was treated with steroids.  She recently had a skin biopsy which showed a granulomatous dermatitis with acid fast organisms, cultured out as M. kansasii.  She presented later with mild confusion and 2 separate enhancing cerebral masses.  MRI revealed multiple lesions in the brain. A left thalamic biopsy was performed to rule out infection.

Com408-2-3.gif (189666 bytes) Com408-2-2.gif (170439 bytes) Com408-2-1.gif (157011 bytes) Com408-2-4-CD20.gif (166272 bytes)Click thumbnails to see pictures.

Panel D is immunohistochemistry for CD20.

How would you work this case up? What is your diagnosisDiscussion

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