双语病例 | 与畸胎瘤相关的边缘性脑炎

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ACR CASE

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History

A 34-year-old woman presents with confusion, auditory hallucinations, and altered mental status worsening over a period of 1-2 weeks. Empiric Acyclovir had no apparent effect; EEG findings were not consistent with status epilepticus.

Question

1.1 Which findings are correct based on the images? (Check all that apply and click the Submit button.)

A、T2 hypointensity within the left mesial temporal lobe

B、Preservation of normal architecture of the left hippocampus

C、Restricted diffusion in a distribution atypical for ischemia

D、T1 hyperintensity within the left mesial temporal lobe

E、T2-weighted and FLAIR hyperintensity within the mesial left temporal lobe

Question

2.1 What should be considered in the differential diagnosis for abnormal T2 and FLAIR signal hyperintensity in the mesial temporal lobe? (Check all that apply and click the Submit button.)

A、Herpes encephalitis

B、Limbic encephalitis

C、Glial neoplasm

D、Ischemia

E、Edema related to seizures

F、CMV encephalitis

Question

3.1 Given that the patient did not respond to Acyclovir and had multiple EEGs not typical for seizures, which of the following are appropriate next step(s)?

(Check all that apply and click the Submit button.)

A、Chest radiograph

B、Ultrasound imaging of the pelvis

C、CT imaging of the abdomen and pelvis

D、Blood work

E、Stereotactic biopsy of the lesion

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解

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