Semonche Alexa, Gomez Pablo, Kolcun John Paul G, Perez-Roman Roberto J, Starke Robert M
Neurological Surgery, University of Miami Miller School of Medicine, Miami, USA.
Neurological Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, USA.
Cureus. 2020 Feb 19;12(2):e7043. doi: 10.7759/cureus.7043.
Primary central nervous system lymphoma (PCNSL) rarely manifests in immunocompetent patients. In such cases, these lesions may mimic more common intracranial bleeding or tumors. We present the case of an elderly patient who presented with a presumed chronic subdural hematoma (SDH); upon surgical intervention, an occult mass was discovered with no evidence of associated hematoma. Biopsy and immunohistochemistry demonstrated PCNSL. Literature review identified six other cases of PCNSL in immunocompetent adults that were initially suspected to be SDH but were finally diagnosed with PCNSL. Our literature review highlights the rarity these cases and the importance of distinguishing intracranial bleeds from PCNSL, as the latter can be treated with chemoradiation with good clinical outcomes.
原发性中枢神经系统淋巴瘤(PCNSL)在免疫功能正常的患者中很少出现。在这种情况下,这些病变可能类似于更常见的颅内出血或肿瘤。我们报告一例老年患者,最初被诊断为慢性硬膜下血肿(SDH);手术干预后,发现一个隐匿性肿块,无相关血肿证据。活检和免疫组化显示为PCNSL。文献回顾发现另外6例免疫功能正常的成年人PCNSL病例,最初怀疑为SDH,但最终诊断为PCNSL。我们的文献回顾强调了这些病例的罕见性以及区分颅内出血和PCNSL的重要性,因为后者可以通过放化疗进行治疗,临床效果良好。