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Dura‐based large B‐cell lymphoma
Author(s) -
Martin Mary Jo Nicewarner,
Schroeder Jason,
Ghatak Nitya R.
Publication year - 2007
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.21.5.a391
Subject(s) - medicine , pathology , meningioma , lymphoma , dura mater , parenchyma , papilledema , differential diagnosis , meninges , anatomy , radiology
Primary central nervous system (CNS) large B‐cell lymphomas are relatively rare and more prone to occur in immunosuppressed patients involving the brain parenchyma. Dura‐based lymphomas are exceedingly rare and mostly are of low‐grade mucosa‐associated lymphoid tissue (MALT) type. We now report an example of dura‐based large B‐cell lymphoma clinically simulating an aggressive meningioma. The patient is a 65‐year‐old woman who had an episode of disorientation. She was found to have mild right papilledema. CT and MRI showed a 4.7 X 2.0 cm extra‐axial mass in the right frontal area involving the dura and extending to the overlying frontal bone. The mass showed ill‐defined areas of moderate enhancement with severe edema of the underlying brain and subfalcine herniation. A partial resection of the tumor with adjacent brain tissue was done. Microscopic study of the tumor using various immunostains showed typical features of a large B‐cell lymphoma. The tumor cells were positive for CD 20 and showed high proliferative index. The tumor invaded the dura and adjacent cranial bone; it infiltrated the brain along the Virchow‐Robin spaces accompanied by edema and severe reactive astrocytosis. No evidence of tumor was found elsewhere in the body. This case indicates that large B‐cell lymphoma should be included in the differential diagnosis of a dura‐based tumor.