Primary diffuse large B-cell central nervous system lymphoma presenting as an acute space-occupying subdural mass

Case report

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Primary dural lymphomas are very rare tumors—usually low-grade B-cell lymphomas of mucosa-associated lymphoid tissue type or marginal zone B-cell lymphomas. Primary dural involvement by diffuse large B-cell lymphoma is extremely rare, with only a few cases reported in the literature. The authors present an unusual case of primary dural involvement by a high-grade diffuse large B-cell lymphoma that presented as an acute subdural space-occupying mass and required emergency neurosurgical intervention.

Abbreviations used in this paper: DLBCL = diffuse large B-cell lymphoma; MALT = mucosa-associated lymphoid tissue; NHL = non-Hodgkin lymphoma; PCNSL = primary CNS lymphoma; SLE = systemic lupus erythematosus.

Article Information

Address correspondence to: Raphael H. Sacho, M.D., M.R.C.S.(Eng), Department of Neurosurgery, Salford Royal NHS Foundation Trust, Stott Lane, Salford M6 8HD, United Kingdom. email: Raphael.Sacho@postgrad.manchester.ac.uk.

Please include this information when citing this paper: published online March 12, 2010; DOI: 10.3171/2010.2.JNS091554.

© AANS, except where prohibited by US copyright law.

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Figures

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    A–F: Contrast-enhanced CT images obtained on patient's first presentation. Note the heterogeneous subdural mass with mass effect and midline shift. G and H: Noncontrast CT images obtained prior to second operation. Note the recurrence of the subdural mass with significant mass effect and midline shift.

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    Intraoperative picture from patient's first craniotomy showing sudural fleshy mass on cortical surface and underlying the dura.

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    A: Subdural tumor mass with dural invasion. H & E, original magnification × 50. B: Sheets of pleomorphic blasts (centroblasts and immunoblasts) consistent with a high-grade lymphoma. H & E, original magnification × 400. C: Membrane positivity for CD20 confirming Blymphocytic differentiation. Original magnification × 630.

References

1

Commins DL: Pathology of primary central nervous system lymphoma. Neurosurg Focus 21:5E22006

2

Deckort MPaulus WMalignant lymphomas. Louis DNOhgaki HWiestler OD: WHO Classification of Tumours of the Central Nervous System ed 4LyonIARC Press2007. 188192

3

Galarza MGazzeri RElfeky HAJohnson RR II: Primary diffuse large B-cell lymphoma of the dura mater and cranial vault. Primary diffuse large B-cell lymphoma of the dura mater and cranial vault. Neurosurg Focus 21:5E102006

4

Goetz PLafuente JRevesz TGalloway MDogan AKitchen N: Primary low-grade B-cell lymphoma of mucosa-associated lymphoid tissue of the dura mimicking the presentation of an acute subdural hematoma. Case report and review of the literature. J Neurosurg 96:6116142002

5

Iwamoto FMAbrey LE: Primary dural lymphomas: a review. Neurosurg Focus 21:5E52006

6

Iwamoto FMDeAngelis LMAbrey LE: Primary dural lymphomas: a clinicopathologic study of treatment and outcome in eight patients. Neurology 66:176317652006

7

Yamada SMIkawa NToyonaga SNakabayashi HChang Park KShimizu K: Primary malignant B-cell-type dural lymphoma: Case report. Surg Neurol 66:5395432006

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