We report a 51-year-old Japanese man with chronic alcoholism who complained of mental confusion following respiratory and intestinal infections. The splenium of the corpus callosum showed hyperintensity on both diffusion-weighted MR images and fluid-attenuated inversion recovery images and hypointensity on T1-weighted images. These findings were resolved on MR images obtained 3 days later. He showed complete neurological recovery within 2 months. We suspected that he had mild encephalopathy with a reversible splenial lesion after systemic viral or bacterial infection.

P i c t u r e 1 . MRI o n a d mi s s i o n s h o we d s we l l i n g o f t h e r i g h t c e r e b r a l h e mi s p h e r e a n d d i l a t i o n o f t h e l a t e r a l v e n t r i c l e . Di f f u s i o n -we i g h t e d i ma g e a n d F L AI R i ma g e d e mo n s t r a t e d a h i g h i n t e n s i t y i n t h e s u b a r a c h n o i d s p a c e o v e r t h e r i g h t h e mi s p h e r e . Ab n o r ma l e n h a n c e me n t wa s o b s e r v e d i n t h e l e p t o me n i n g e s o v e r t h e r i g h t h e mi s p h e r e . a : d i f f u s i o n -we i g h t e d i ma g e , b : T 1 -we i g h t e d i ma g e , c : F L AI R i ma g e , d -e : e n h a n c e d i ma g e s a f t e r g a d o l i n i u m a d mi n i s t r a t i o n .

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P i c t u r e . A: T h e f i r s t d i f f u s i o n -we i g h t e d i ma g e s ( DWI ) p e r f o r me d b e f o r e t h e o n s e t o f d e me n t i a . Ap p a r e n t h i g h -i n t e n s i t y l e s i o n i s n o t s e e n . B : S t a n d a r d i z e d i ma g e s o f t h e f i r s t DWI . Hi g h -i n t e n s i t y l e s i o n s a r e o b s e r v e d i n t h e l e f t f r o n t a l l o b e c o r t i c e s , c o r t i c e s o f t h e b i l a t e r a l c i n g u l a t e g y r u s a n d p r e c u n e u s , a n d t h e l e f t p a r i e t o -o c c i p i t a l c o r t e x . C: DWI p e r f o r me d t h r e e we e k s a f t e r t h e o n s e t o f d e me n t i a . Hi g h -i n t e n s i t y l e s i o n s i n c r e a s e d t h e s i g n a l i n t e n s i t y a n d t h e a r e a . L e f t c a u d a t e n u c l e u s s h o ws h i g h i n t e n s i t y . D: DWI p e r f o r me d 2 mo n t h s a f t e r t h e o n s e t o f d e me n t i a . Wi d e s p r e a d h i g h -i nt e n s i t y c o r t i c a l l e s i o n wa s o b s e r v e d a n d t h e b i l a t e r a l c a u d a t e n u c l e i d e mo n s t r a t e d h i g h i n t e n s i t y .Co r t i c a l a t r o p h y a n d v e n t r i c u l a r e n l a r g e me n t we r e a l s o n o t i c e d .

A case of angiocentric T-cell lymphoma with glabellar skin being the only affected site was reported. A 43-year-old woman had a several months’ history of glabellar swelling followed by progressive and destructive ulceration of the region. Histopathology of the biopsied specimen showed panniculitis with atypical lymphocytes and degenerative vessels filled with atypical cells. Most of the infiltrated lymphocytes were positive for CD2, CD3, CD4 and CD5. Antibodies to Epstein-Barr virus were detected in the patient serum. Intensive chemotherapy using a protocol of the L17M regimen was partially effective for clinical manifestations. Angiocentric T-cell lymphoma presenting as lethal midline granuloma is a rare but distinct entity with an acute fatal course.