Ochiai Hidenobu, Kawano Hirokazu, Miyaoka Ryo, Kawano Noriaki, Shimao Yoshiya, Kawasaki Kensaku
Department of Neurosurgery, Miyazaki Prefectural Hospital, Miyazaki, Miyazaki, Japan.
Neurol Med Chir (Tokyo). 2010;50(7):595-8. doi: 10.2176/nmc.50.595.
A 72-year-old man presented with an extremely rare case of primary diffuse large B-cell lymphomas (DLBCLs) of the dura and scalp existing independently without intervening cranial vault invasion. The patient presented with an indolent mass lesion at the left temporal parietal scalp. Magnetic resonance imaging and computed tomography revealed a solid homogeneously enhanced mass in the left temporoparietal scalp, and an extra-axial intracranial mass that existed just below the scalp without intervening skull invasion. The patient underwent gross total resection of these lesions via a left frontotemporoparietal craniotomy. Histological examination of the masses revealed DLBCLs. The patient received whole-brain radiation therapy, and subsequent chemotherapy with cyclophosphamide, adriamycin, vincristine, and prednisolone. He was discharged without neurological deficit. The present case of DLBCLs in the scalp and dura without intervening skull bone invasion indicates that malignant lymphoma should be considered in the differential diagnosis of scalp and dural tumors without intervening skull bone invasion.
一名72岁男性患者,出现了极为罕见的原发性硬脑膜和头皮弥漫性大B细胞淋巴瘤(DLBCL),该肿瘤独立存在,未侵犯中间的颅顶。患者左侧颞顶头皮出现一个无痛性肿块病变。磁共振成像和计算机断层扫描显示,左侧颞顶头皮有一个均匀强化的实性肿块,以及一个位于头皮下方、未侵犯颅骨的轴外颅内肿块。患者通过左额颞顶开颅手术对这些病变进行了全切除。肿块的组织学检查显示为DLBCL。患者接受了全脑放射治疗,随后接受了环磷酰胺、阿霉素、长春新碱和泼尼松龙的化疗。他出院时没有神经功能缺损。本病例中头皮和硬脑膜的DLBCL未侵犯颅骨,提示在诊断未侵犯颅骨的头皮和硬脑膜肿瘤时,应考虑恶性淋巴瘤的鉴别诊断。