Ramnarayan R, Anilkumar Tv, Nayar Rani
Department of Neurosurgery, Apollo Hospital, Chennai, India.
J Neurosci Rural Pract. 2013 Apr;4(2):216-9. doi: 10.4103/0976-3147.112774.
A 59-year-old man was found on the road with multiple injuries. CT scan showed a hypodense extra axial lesion in the left fronto-temporal region suggestive of chronic subdural haematoma. He was treated conservatively but did not improve. He underwent craniectomy after lesion was shown to be increasing in size, only solid tissue was seen which was not biopsied. Patient made good recovery after steroids were put on. He deteriorated again 6 weeks later and radiology showed the frontal lesion without involvement of the brain and with minimal enhancement and mass effect. He underwent biopsy decompression of the lesion with steroids, post-operatively he improved well, but deteriorated when the steroids were tapered. Histopathology report was Non-Hodgkin's lymphoma. No primary was found and the patient died during oncology treatment. This illustrates manifestation of primary dural lymphoma radiologically mimicking chronic subdural haematoma, another common disorder.
一名59岁男性被发现倒在路上,身上有多处损伤。CT扫描显示左额颞区有一个低密度轴外病变,提示慢性硬膜下血肿。他接受了保守治疗,但病情没有改善。在病变显示出增大后,他接受了颅骨切除术,术中仅见实性组织,未进行活检。使用类固醇后患者恢复良好。6周后他再次恶化,影像学检查显示额叶病变未累及脑实质,强化及占位效应轻微。他接受了病变的活检减压并使用了类固醇,术后恢复良好,但在类固醇减量时病情恶化。组织病理学报告为非霍奇金淋巴瘤。未发现原发灶,患者在肿瘤治疗期间死亡。这例病例说明了原发性硬脑膜淋巴瘤在影像学上表现为酷似慢性硬膜下血肿,而慢性硬膜下血肿是另一种常见疾病。