Hamamoto Ryo, Kawasaki Toshinari, Oda Masashi, Sumiyoshi Sosuke, Hayashi Kosuke, Kobayashi Tamaki, Ioroi Yoshihiko, Uchiyama Tatsuki, Takayama Motohiro, Saiki Masaaki
Department of Neurosurgery Japanese Red Cross Otsu Hospital, Otsu, Japan.
Department of Hematology Japanese Red Cross Otsu Hospital, Otsu, Japan.
Surg Neurol Int. 2024 Mar 29;15:113. doi: 10.25259/SNI_792_2023. eCollection 2024.
Primary extranodal marginal zone mucosa-associated lymphoid tissue-type B-cell lymphoma (EMZMBCL), which presents as a dural mass, is a rare intracranial tumor that mimics a subdural hematoma or meningioma.
A 49-year-old woman presented to our hospital with transient right upper limb paresis, dysarthria for 10 min, and ongoing right upper-limb numbness. Computed tomography (CT) of the head revealed extra-axial lesions in the left frontal and parietal lobes. Based on the initial CT findings in the emergency room, an acute subdural hematoma was suspected. However, meningiomas and other intracranial tumors were also listed as differential diagnoses because there was no history of head trauma or coagulation abnormalities on blood examination, and further imaging studies were performed. Imaging findings suggested a subdural neoplastic lesion. A partial resection was performed for the lesion. Based on histopathological and immunohistochemical examinations, the patient was diagnosed with EMZMBCL. Whole-brain and intensity-modulated radiation therapies were administered as adjuvant therapies. The patient was discharged without neurological deficits.
EMZMBCL is a rare disease that should be considered in the differential diagnosis of subdural lesions, especially when there is no history of trauma or abnormalities in the coagulation system. The patient had a favorable outcome after selecting radiotherapy as the adjuvant therapy.
原发性结外边缘区黏膜相关淋巴组织型B细胞淋巴瘤（EMZMBCL）表现为硬脑膜肿块，是一种罕见的颅内肿瘤，易被误诊为硬膜下血肿或脑膜瘤。
一名49岁女性因短暂性右上肢轻瘫、构音障碍10分钟及持续性右上肢麻木就诊于我院。头颅计算机断层扫描（CT）显示左额叶和顶叶有轴外病变。根据急诊室的初始CT检查结果，怀疑为急性硬膜下血肿。然而，由于患者无头部外伤史且血液检查无凝血异常，脑膜瘤和其他颅内肿瘤也被列为鉴别诊断，因此进行了进一步的影像学检查。影像学检查结果提示为硬膜下肿瘤性病变。对该病变进行了部分切除术。根据组织病理学和免疫组化检查，患者被诊断为EMZMBCL。给予全脑和调强放疗作为辅助治疗。患者出院时无神经功能缺损。
EMZMBCL是一种罕见疾病，在硬膜下病变的鉴别诊断中应予以考虑，尤其是在无创伤史或凝血系统异常的情况下。患者选择放疗作为辅助治疗后预后良好。
