Neurosurgical Unit of Miulli Hospital, Acquaviva delle Fonti, Italy.
Neurosurgical Unit of San Giovanni Bosco Hospital, Naples, Italy.
Acta Neurol Belg. 2021 Apr;121(2):409-414. doi: 10.1007/s13760-019-01188-2. Epub 2019 Jul 12.
Primary dural lymphoma (PDL) is an extremely rare subtype of primary central nervous system lymphoma arising from the dura mater in absence of systemic disease. The most common histological type is the low-grade marginal zone lymphoma, whereas high-grade lymphomas are unusual. We present a case of primary diffuse large B-cell lymphoma, presenting as PDL in the posterior fossa, originating from the dura mater of the petrous bone covering the surface of the left cerebellum, a location not previously described. A 65-year-old woman presented with sudden onset of severe dizziness was admitted in otolaryngology department then transferred to neurosurgery ward. CT scan revealed a large lesion involving left cerebellum, subsequent MRI of the brain demonstrated an enhancing mass suggestive for petrous bone meningioma. The tumor was excised, and the histopathological examination unexpectedly revealed a diffuse large B-cell lymphoma. The patient received postoperative chemoradiotherapy. 20 months after surgery a good outcome was registered. Due to the rarity of primary dural lymphomas no standard treatment is available, however, gross total or subtotal resection followed by adjuvant therapy seems to be a good choice to manage the pathology.
原发性脑脊膜淋巴瘤（PDL）是一种极为罕见的原发性中枢神经系统淋巴瘤亚型，起源于硬脑膜，无系统性疾病。最常见的组织学类型是低级别的边缘区淋巴瘤，而高级别淋巴瘤则不常见。我们报告了一例原发性弥漫性大 B 细胞淋巴瘤，表现为后颅窝的 PDL，起源于覆盖左小脑表面的岩骨硬脑膜，这是以前未曾描述过的部位。一名 65 岁女性突发严重头晕，被收入耳鼻喉科，随后转入神经外科病房。CT 扫描显示左小脑有一个大病灶，随后的脑部 MRI 显示一个增强的肿块，提示为岩骨脑膜瘤。肿瘤被切除，组织病理学检查出人意料地显示为弥漫性大 B 细胞淋巴瘤。患者接受了术后放化疗。手术后 20 个月，患者病情良好。由于原发性脑脊膜淋巴瘤非常罕见，因此尚无标准的治疗方法，然而，大体全切除或次全切除后辅助治疗似乎是治疗该疾病的一个不错的选择。
