{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T16:07:59Z","timestamp":1776096479040,"version":"3.50.1"},"reference-count":44,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","license":[{"start":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T00:00:00Z","timestamp":1768780800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurosurg Case Lessons"],"published-print":{"date-parts":[[2026,1,19]]},"abstract":"\n BACKGROUND<\/jats:title>\n Lymphocytic vasculitis (LV), a histopathological subtype of primary angiitis of the CNS, is a rare inflammatory disorder that often presents as mass-like lesions mimicking malignant brain tumors. Owing to its rarity, the characteristics of LV remain poorly understood.<\/jats:p>\n <\/jats:sec>\n \n OBSERVATIONS<\/jats:title>\n The authors report the case of a young woman who presented with progressive headache. MRI revealed a solitary, ring-enhancing lesion with marked perifocal edema. Fluorodeoxyglucose positron emission tomography (FDG-PET) demonstrated relatively low uptake at the lesion margin, whereas fluciclovine-PET showed mild uptake. Given the high intracranial pressure and uncertain diagnosis, gross-total resection was performed. Histopathological analysis confirmed LV, characterized by perivascular lymphocytic infiltration, fibrin exudation, and the absence of neoplastic or demyelinating features. The patient did not receive additional immunosuppressive therapy and remained disease free for 12 months.<\/jats:p>\n <\/jats:sec>\n \n LESSONS<\/jats:title>\n To the best of the authors\u2019 knowledge, this is the first reported case of a solitary intracranial LV that was successfully managed with resection alone. This case suggests that resection may be a possible therapeutic option for select patients, particularly those with solitary lesions and negative autoimmune profiles. FDG-PET and fluciclovine-PET with MRI may provide supportive information for distinguishing LV from malignant neoplastic tumors.<\/jats:p>\n \n https:\/\/thejns.org\/doi\/10.3171\/CASE25705<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/case25705","type":"journal-article","created":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T12:00:01Z","timestamp":1769083201000},"source":"Crossref","is-referenced-by-count":0,"title":["Complete remission of intracranial lymphocytic vasculitis following resection: illustrative case"],"prefix":"10.3171","volume":"11","author":[{"given":"Osamu","family":"Yazawa","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Yokohama City University, Graduate School of Medicine, Yokohama"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6895-9013","authenticated-orcid":true,"given":"Kensuke","family":"Tateishi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Yokohama City University, Graduate School of Medicine, Yokohama"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naoki","family":"Ikegaya","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Yokohama City University, Graduate School of Medicine, Yokohama"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takeaki","family":"Kawai","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Yokohama City University, Graduate School of Medicine, Yokohama"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jotaro","family":"Harada","sequence":"additional","affiliation":[{"name":"Department of Molecular Pathology, Yokohama City University, Graduate School of Medicine, Yokohama"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7269-5903","authenticated-orcid":true,"given":"Ayumi","family":"Kato","sequence":"additional","affiliation":[{"name":"Department of Radiology, Yokohama City University, Graduate School of Medicine, Yokohama"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0271-3317","authenticated-orcid":true,"given":"Keisuke","family":"Morihara","sequence":"additional","affiliation":[{"name":"Department of Neurology, Yokohama City University, Graduate School of Medicine, Yokohama"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shoji","family":"Yamanaka","sequence":"additional","affiliation":[{"name":"Department of Pathology, Yokohama City University Hospital, Yokohama, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daisuke","family":"Utsunomiya","sequence":"additional","affiliation":[{"name":"Department of Radiology, Yokohama City University, Graduate School of Medicine, Yokohama"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satoshi","family":"Fujii","sequence":"additional","affiliation":[{"name":"Department of Molecular Pathology, Yokohama City University, Graduate School of Medicine, Yokohama"},{"name":"Department of Pathology, Yokohama City University Hospital, Yokohama, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9961-2693","authenticated-orcid":true,"given":"Fumiaki","family":"Tanaka","sequence":"additional","affiliation":[{"name":"Department of Neurology, Yokohama City University, Graduate School of Medicine, Yokohama"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9977-9373","authenticated-orcid":true,"given":"Tetsuya","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Yokohama City University, Graduate School of Medicine, Yokohama"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"1","key":"bib1","series-title":"Sci Rep","first-page":"13494","article-title":"Primary CNS vasculitis (PCNSV): a cohort study","volume":"12","author":"Agarwal","year":"2022","unstructured":"Agarwal ASharma JSrivastava MVPPrimary CNS vasculitis (PCNSV): a cohort study. Sci Rep. 2022;12(1):13494."},{"issue":"2","key":"bib2","series-title":"Folia Neuropathol","first-page":"187","article-title":"Primary angiitis of the central nervous system: a study of histopathological patterns and review of the literature","volume":"52","author":"Suri","year":"2014","unstructured":"Suri VKakkar ASharma MCPadma MVGarg ASarkar C.Primary angiitis of the central nervous system: a study of histopathological patterns and review of the literature. Folia Neuropathol. 2014;52(2):187-196."},{"issue":"1","key":"bib3","series-title":"Rev Bras Reumatol","first-page":"90","article-title":"Polymyositis associated with lymphocytic arteritis of the central nervous system","volume":"50","author":"da Costa","year":"2010","unstructured":"da Costa IPPradebon EPCampos JVMelo FSTavares FMAA.Polymyositis associated with lymphocytic arteritis of the central nervous system. Rev Bras Reumatol. 2010;50(1):90-95."},{"key":"bib4","series-title":"Clin Neurol Neurosurg","first-page":"106297","article-title":"Characteristics of mass lesion presentation of primary angiitis of the central nervous system: a single center 11-year retrospective case-series study","volume":"199","author":"Wang","year":"2020","unstructured":"Wang QWang ZWang KZheng KQi X.Characteristics of mass lesion presentation of primary angiitis of the central nervous system: a single center 11-year retrospective case-series study. 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AJNR Am J Neuroradiol. 2005;26(3):642-645."},{"issue":"5","key":"bib13","series-title":"Neurology","first-page":"453","article-title":"CNS vasculitis in a patient with MS on daclizumab monotherapy","volume":"80","author":"Ohayon","year":"2013","unstructured":"Ohayon JOh URichert NCNS vasculitis in a patient with MS on daclizumab monotherapy. Neurology. 2013;80(5):453-457."},{"issue":"1","key":"bib14","series-title":"J Neurosurg Pediatr","first-page":"62","article-title":"Angiography-negative primary angiitis of the central nervous system in childhood","volume":"13","author":"Park","year":"2014","unstructured":"Park MSMarlin AEGaskill SJ.Angiography-negative primary angiitis of the central nervous system in childhood. J Neurosurg Pediatr. 2014;13(1):62-67."},{"issue":"5","key":"bib15","series-title":"J Neurol","first-page":"1354","article-title":"Idiopathic hypereosinophilic syndrome: a new cause of vasculitis of the central nervous system","volume":"262","author":"Rice","year":"2015","unstructured":"Rice CMKurian KMRenowden SWhiteway APrice CScolding NJ.Idiopathic hypereosinophilic syndrome: a new cause of vasculitis of the central nervous system. J Neurol. 2015;262(5):1354-1359."},{"issue":"2","key":"bib16","series-title":"Pediatr Investig","first-page":"140","article-title":"A 5-year-old child presenting with tumor-like primary angiitis of the central nervous system","volume":"6","author":"Zhuo","year":"2022","unstructured":"Zhuo XFeng WZhou JA 5-year-old child presenting with tumor-like primary angiitis of the central nervous system. Pediatr Investig. 2022;6(2):140-143."},{"key":"bib17","series-title":"Front Neurol","first-page":"1363985","article-title":"Primary CNS vasculitis: insights into clinical, neuropathological, and neuroradiological characteristics","volume":"15","author":"Sheikh","year":"2024","unstructured":"Sheikh TSRozenberg AMerhav GShifrin AStein PShelly S.Primary CNS vasculitis: insights into clinical, neuropathological, and neuroradiological characteristics. Front Neurol. 2024;15:1363985."},{"issue":"7","key":"bib18","series-title":"Neurology","first-page":"e209819","article-title":"Pearls & oy-sters: tumour-like mass lesion secondary to primary CNS vasculitis","volume":"103","author":"Roberts","year":"2024","unstructured":"Roberts JINg DKapadia R.Pearls & oy-sters: tumour-like mass lesion secondary to primary CNS vasculitis. 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Front Pediatr. 2022;10:794294."},{"issue":"2","key":"bib21","series-title":"AJNR Am J Neuroradiol","first-page":"278","article-title":"62Cu-diacetyl-bis (N4-methylthiosemicarbazone) PET in human gliomas: comparative study with [18F]fluorodeoxyglucose and L-methyl-[11C]methionine PET","volume":"35","author":"Tateishi","year":"2014","unstructured":"Tateishi KTateishi UNakanowatari S62Cu-diacetyl-bis (N4-methylthiosemicarbazone) PET in human gliomas: comparative study with [18F]fluorodeoxyglucose and L-methyl-[11C]methionine PET. AJNR Am J Neuroradiol. 2014;35(2):278-284."},{"issue":"6","key":"bib22","series-title":"Eur J Nucl Med Mol Imaging","first-page":"1353","article-title":"18F-Fluciclovine (18F-FACBC) PET imaging of recurrent brain tumors","volume":"47","author":"Michaud","year":"2020","unstructured":"Michaud LBeattie BJAkhurst T18F-Fluciclovine (18F-FACBC) PET imaging of recurrent brain tumors. Eur J Nucl Med Mol Imaging. 2020;47(6):1353-1367."},{"issue":"1","key":"bib1","series-title":"Sci Rep","first-page":"13494","article-title":"Primary CNS vasculitis (PCNSV): a cohort study","volume":"12","author":"Agarwal","year":"2022","unstructured":"Agarwal ASharma JSrivastava MVPPrimary CNS vasculitis (PCNSV): a cohort study. Sci Rep. 2022;12(1):13494."},{"issue":"2","key":"bib2","series-title":"Folia Neuropathol","first-page":"187","article-title":"Primary angiitis of the central nervous system: a study of histopathological patterns and review of the literature","volume":"52","author":"Suri","year":"2014","unstructured":"Suri VKakkar ASharma MCPadma MVGarg ASarkar C.Primary angiitis of the central nervous system: a study of histopathological patterns and review of the literature. Folia Neuropathol. 2014;52(2):187-196."},{"issue":"1","key":"bib3","series-title":"Rev Bras Reumatol","first-page":"90","article-title":"Polymyositis associated with lymphocytic arteritis of the central nervous system","volume":"50","author":"da Costa","year":"2010","unstructured":"da Costa IPPradebon EPCampos JVMelo FSTavares FMAA.Polymyositis associated with lymphocytic arteritis of the central nervous system. Rev Bras Reumatol. 2010;50(1):90-95."},{"key":"bib4","series-title":"Clin Neurol Neurosurg","first-page":"106297","article-title":"Characteristics of mass lesion presentation of primary angiitis of the central nervous system: a single center 11-year retrospective case-series study","volume":"199","author":"Wang","year":"2020","unstructured":"Wang QWang ZWang KZheng KQi X.Characteristics of mass lesion presentation of primary angiitis of the central nervous system: a single center 11-year retrospective case-series study. Clin Neurol Neurosurg. 2020;199:106297."},{"issue":"11","key":"bib5","series-title":"AJNR Am J Neuroradiol","first-page":"2075","article-title":"Tumefactive primary central nervous system vasculitis: imaging findings of a rare and underrecognized neuroinflammatory disease","volume":"41","author":"Suthiphosuwan","year":"2020","unstructured":"Suthiphosuwan SBharatha AHsu CCTumefactive primary central nervous system vasculitis: imaging findings of a rare and underrecognized neuroinflammatory disease. AJNR Am J Neuroradiol. 2020;41(11):2075-2081."},{"key":"bib6","series-title":"Ther Adv Neurol Disord","first-page":"1756286418785071","article-title":"Primary angiitis of the central nervous system: diagnosis and treatment","volume":"11","author":"Beuker","year":"2018","unstructured":"Beuker CSchmidt AStrunk DPrimary angiitis of the central nervous system: diagnosis and treatment. Ther Adv Neurol Disord. 2018;11:1756286418785071."},{"issue":"1","key":"bib7","series-title":"Clin Cancer Res","first-page":"116","article-title":"Intraoperative integrated diagnostic system for malignant central nervous system tumors","volume":"30","author":"Hayashi","year":"2024","unstructured":"Hayashi TTateishi KMatsuyama SIntraoperative integrated diagnostic system for malignant central nervous system tumors. Clin Cancer Res. 2024;30(1):116-126."},{"issue":"3","key":"bib8","series-title":"Arthritis Rheum","first-page":"995","article-title":"Primary necrotizing lymphocytic central nervous system vasculitis due to perforin deficiency in a four-year-old girl","volume":"56","author":"Moshous","year":"2007","unstructured":"Moshous DFeyen OLankisch PPrimary necrotizing lymphocytic central nervous system vasculitis due to perforin deficiency in a four-year-old girl. Arthritis Rheum. 2007;56(3):995-999."},{"key":"bib9","series-title":"Mult Scler Relat Disord","first-page":"48","article-title":"MOG antibody disease manifesting as progressive cognitive deterioration and behavioral changes with primary central nervous system vasculitis","volume":"30","author":"Baba","year":"2019","unstructured":"Baba TShinoda KWatanabe MMOG antibody disease manifesting as progressive cognitive deterioration and behavioral changes with primary central nervous system vasculitis. Mult Scler Relat Disord. 2019;30:48-50."},{"issue":"5","key":"bib10","series-title":"Neurol Neuroimmunol Neuroinflamm","first-page":"e1048","article-title":"CNS lymphocytic vasculitis in a young woman with COVID-19 infection","volume":"8","author":"Timmons","year":"2021","unstructured":"Timmons GMRempe TBevins EACNS lymphocytic vasculitis in a young woman with COVID-19 infection. Neurol Neuroimmunol Neuroinflamm. 2021;8(5):e1048."},{"issue":"2","key":"bib11","series-title":"Neuropathology","first-page":"158","article-title":"A case of childhood unilateral relapsing primary angiitis of the central nervous system","volume":"43","author":"Onomura","year":"2023","unstructured":"Onomura HFurukawa SNishida SKitagawa SYoshida MIto Y.A case of childhood unilateral relapsing primary angiitis of the central nervous system. Neuropathology. 2023;43(2):158-163."},{"issue":"3","key":"bib12","series-title":"AJNR Am J Neuroradiol","first-page":"642","article-title":"Lymphocytic vasculitis mimicking aggressive multifocal cerebral neoplasm: MR imaging and MR spectroscopic appearance","volume":"26","author":"Panchal","year":"2005","unstructured":"Panchal NJNiku SImbesi SG.Lymphocytic vasculitis mimicking aggressive multifocal cerebral neoplasm: MR imaging and MR spectroscopic appearance. AJNR Am J Neuroradiol. 2005;26(3):642-645."},{"issue":"5","key":"bib13","series-title":"Neurology","first-page":"453","article-title":"CNS vasculitis in a patient with MS on daclizumab monotherapy","volume":"80","author":"Ohayon","year":"2013","unstructured":"Ohayon JOh URichert NCNS vasculitis in a patient with MS on daclizumab monotherapy. Neurology. 2013;80(5):453-457."},{"issue":"1","key":"bib14","series-title":"J Neurosurg Pediatr","first-page":"62","article-title":"Angiography-negative primary angiitis of the central nervous system in childhood","volume":"13","author":"Park","year":"2014","unstructured":"Park MSMarlin AEGaskill SJ.Angiography-negative primary angiitis of the central nervous system in childhood. J Neurosurg Pediatr. 2014;13(1):62-67."},{"issue":"5","key":"bib15","series-title":"J Neurol","first-page":"1354","article-title":"Idiopathic hypereosinophilic syndrome: a new cause of vasculitis of the central nervous system","volume":"262","author":"Rice","year":"2015","unstructured":"Rice CMKurian KMRenowden SWhiteway APrice CScolding NJ.Idiopathic hypereosinophilic syndrome: a new cause of vasculitis of the central nervous system. J Neurol. 2015;262(5):1354-1359."},{"issue":"2","key":"bib16","series-title":"Pediatr Investig","first-page":"140","article-title":"A 5-year-old child presenting with tumor-like primary angiitis of the central nervous system","volume":"6","author":"Zhuo","year":"2022","unstructured":"Zhuo XFeng WZhou JA 5-year-old child presenting with tumor-like primary angiitis of the central nervous system. Pediatr Investig. 2022;6(2):140-143."},{"key":"bib17","series-title":"Front Neurol","first-page":"1363985","article-title":"Primary CNS vasculitis: insights into clinical, neuropathological, and neuroradiological characteristics","volume":"15","author":"Sheikh","year":"2024","unstructured":"Sheikh TSRozenberg AMerhav GShifrin AStein PShelly S.Primary CNS vasculitis: insights into clinical, neuropathological, and neuroradiological characteristics. Front Neurol. 2024;15:1363985."},{"issue":"7","key":"bib18","series-title":"Neurology","first-page":"e209819","article-title":"Pearls & oy-sters: tumour-like mass lesion secondary to primary CNS vasculitis","volume":"103","author":"Roberts","year":"2024","unstructured":"Roberts JINg DKapadia R.Pearls & oy-sters: tumour-like mass lesion secondary to primary CNS vasculitis. Neurology. 2024;103(7):e209819."},{"issue":"9","key":"bib19","series-title":"Clin Nucl Med","first-page":"886","article-title":"18 F-FDG brain PET\/MRI in granulomatous primary angiitis of the central nervous system","volume":"49","author":"Sagnelli","year":"2024","unstructured":"Sagnelli MAlkabie SFranceschi AM.18 F-FDG brain PET\/MRI in granulomatous primary angiitis of the central nervous system. Clin Nucl Med. 2024;49(9):886-889."},{"key":"bib20","series-title":"Front Pediatr","first-page":"794294","article-title":"Case report: interest of positron emission tomography in pediatric small vessel primary angiitis of the central nervous system","volume":"10","author":"Belcour","year":"2022","unstructured":"Belcour MDontaine PMonier ACase report: interest of positron emission tomography in pediatric small vessel primary angiitis of the central nervous system. Front Pediatr. 2022;10:794294."},{"issue":"2","key":"bib21","series-title":"AJNR Am J Neuroradiol","first-page":"278","article-title":"62Cu-diacetyl-bis (N4-methylthiosemicarbazone) PET in human gliomas: comparative study with [18F]fluorodeoxyglucose and L-methyl-[11C]methionine PET","volume":"35","author":"Tateishi","year":"2014","unstructured":"Tateishi KTateishi UNakanowatari S62Cu-diacetyl-bis (N4-methylthiosemicarbazone) PET in human gliomas: comparative study with [18F]fluorodeoxyglucose and L-methyl-[11C]methionine PET. AJNR Am J Neuroradiol. 2014;35(2):278-284."},{"issue":"6","key":"bib22","series-title":"Eur J Nucl Med Mol Imaging","first-page":"1353","article-title":"18F-Fluciclovine (18F-FACBC) PET imaging of recurrent brain tumors","volume":"47","author":"Michaud","year":"2020","unstructured":"Michaud LBeattie BJAkhurst T18F-Fluciclovine (18F-FACBC) PET imaging of recurrent brain tumors. 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