A Case of Epstein-Barr Virus Encephalitis Misdiagnosed as Glioma

Yinuo Liu; Ru Liu

doi:10.71321/c09vcg29

Authors

Yinuo Liu Department of Neurology, The First Afliated Hospital of Shandong First Medical University& Shandong Provincial Qianfoshan Hospital, Shandong institute of Neuroimmunology,Jinan, China
Ru Liu Department of Neurology, The First Afliated Hospital of Shandong First Medical University& Shandong Provincial Qianfoshan Hospital, Shandong institute of Neuroimmunology,Jinan, China

DOI:

https://doi.org/10.71321/c09vcg29

Keywords:

Epstein-Barr Virus Encephalitis, Glioma, Brain biopsy, Tumor-like lesions

Abstract

Epstein-Barr virus (EBV) infection can cause central nervous system damage, primarily manifesting as encephalitis, with diverse imaging presentations. We report a case of an EBV-infected patient who presented clinically with cognitive impairment and limb convulsions. Serum and cerebrospinal fluid tests were positive for EBV viral capsid antigen IgM. Cranial MRI revealed multifocal white matter lesions distributed along the lateral ventricles, demonstrating T1 and T2 hyperintensity with associated diffusion restriction in the involved areas, patchy enhancement, and a tumor-mimicking appearance with significant mass effect. Brain biopsy confirmed viral encephalitis. After treatment with antiviral agents and corticosteroids, the patient's symptoms improved. Follow-up cranial MRI one month later showed significant reduction of the lesions. In clinical practice, it is important to be alert to the tumor-like imaging manifestations of EBV encephalitis. Pathological biopsy of brain tissue plays a crucial role in distinguishing this condition from diseases such as glioma.

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