Intravascular XXXX of central nervous system due to metastatic @entity0 : A case report.

@entity1 @entity4798 @entity0 @entity5 @entity5962 @entity189 @entity6831 @entity1188 @entity5822 @entity3
UNASSIGNED: Central nervous system (CNS) involvement by @entity5 is well-recognized and typically presents with multifocal solid @entity5 within the brain @entity6831 . We describe herein a histologically very rare case of CNS @entity3 in a 52-year-old @entity1 who presented with mental status changes. Post mortem examination revealed extensive CNS involvement by metastatic @entity0 , characterized by the presence of @entity5 cells diffusely present within capillaries without parenchymal or perivascular invasion, and acute ischemic changes/ @entity1188 bilaterally involving multiple areas. The @entity5 cells were found predominantly in the cerebral cortices and deep gray matter structures. Pre-mortem magnetic resonance and CT imaging of the brain did not identify @entity5 ; however, widespread ischemic changes (i.e. @entity4798 ) were identified. Inflammatory @entity0 is well-known to have a predilection for spread through lymphovascular spaces. Post mortem examination revealed @entity5 involvement of bilateral lungs, heart and bladder, with sinusoidal spread in the liver and lymph nodes and prominent involvement of the splenic red pulp in addition to extensive vascular involvement of the brain and spinal cord without a discrete mass, despite the presence of widely metastatic disease. The @entity5 cells in the CNS were strongly immunoreactive for pancytokeratin, @entity5962 , @entity5822 , epithelial membrane antigen and CAM 5.2. This unique histologic pattern of @entity5 spread is considered to represent "intravascular @entity189 " in the CNS, and most likely the cause of the @entity1 's widespread ischemic injuries.
