Cancer-associated Thrombosis Presenting as Multiple Brain Infarctions during Complete Remission of Follicular Lymphoma.

Intern MedMar 10, 2026 (epub)
Case ReportNeurologyHematologyOncology (Medical)Radiology (Diagnostic)

Taichiro Tokura, Satoshi Sakai, Youhei Imai et al.

✦ AI-curated · Sources linked

Case in brief

A 76-year-old man with follicular lymphoma in complete remission after four cycles of R-CHOP and pegfilgrastim developed dysarthria and right upper-limb paresis. Brain MRI showed multiple infarctions with a positive three-territory sign, while laboratory tests showed leukocytosis and thrombocytopenia. Whole-body CT confirmed remission and showed no thrombosis. He received unfractionated heparin followed by apixaban, with neurological improvement, and was discharged without bleeding or neurological sequelae.

What made this case unusual

Cancer-associated thrombosis presented as multiple brain infarctions despite complete remission of an indolent lymphoma; whole-body CT showed no thrombosis, and thrombocytopenia complicated the anticoagulation context.

Diagnostic / clinical pearl

Multiple infarctions across three vascular territories can point to cancer-associated brain infarction, even when lymphoma is in complete remission and imaging shows no other thrombosis.

Why it matters

The reported neurological improvement without bleeding shows that anticoagulation was feasible in this patient despite thrombocytopenia.

Source

PubMed · PMID 41813170

Published in Intern Med. This summary was written by xxcode from the publication's abstract and metadata. It is not peer reviewed and is not a substitute for the original article. For clinical decisions, review the original publication.

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