Kumarasamy Sivaraman, Garg Kanwaljeet, Verma Satish Kumar, Sharma M C, Garg Ajay, Chandra Poodipedi Sarat, Kale Shashank Sharad
Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.
Department of Neuropathology, All India Institute of Medical Sciences, New Delhi, India.
Surg Neurol Int. 2024 Jul 26;15:261. doi: 10.25259/SNI_360_2024. eCollection 2024.
Primary non-Hodgkin's lymphoma with multiple extra- and intra-calvarial extensions without systemic spread in an immunocompetent patient is extremely rare. They masquerade commonly as meningioma and can present as mass lesions with raised intracranial pressure.
We report one such case of primary diffuse large B-cell lymphoma (DLBCL) in a young female involving the scalp, dural involvement in the right frontal region, left parietal, and posterior fossa and mimicking both clinically and radiologically as meningioma. She was managed surgically. Histological examination showed features suggestive of DLBCL (germinal center type). She was planned for adjuvant therapy. However, at 2 months following surgery, she succumbed due to systemic involvement of the disease.
DLBCL is seen rarely in neurosurgical practice. They can present as tumors with adjacent extra- and intra-cranial masses. They pose a diagnostic challenge as it can be easily confused with meningioma. Tumor resection is performed to confirm diagnosis and in patients who present with raised intracranial pressure. Chemotherapy is the preferred treatment, and adjuvant therapy should be started early.
在免疫功能正常的患者中，原发性非霍奇金淋巴瘤伴有多个颅骨内外扩展且无全身扩散极为罕见。它们通常伪装成脑膜瘤，可表现为伴有颅内压升高的肿块病变。
我们报告了一例年轻女性原发性弥漫性大B细胞淋巴瘤（DLBCL），累及头皮，右侧额叶、左侧顶叶和后颅窝硬脑膜受累，临床和影像学表现均酷似脑膜瘤。对其进行了手术治疗。组织学检查显示具有DLBCL（生发中心型）的特征。计划对其进行辅助治疗。然而，术后2个月，她因疾病全身扩散而死亡。
DLBCL在神经外科实践中很少见。它们可表现为伴有相邻颅内和颅外肿块的肿瘤。它们构成了诊断挑战，因为很容易与脑膜瘤混淆。进行肿瘤切除以确诊，并用于颅内压升高的患者。化疗是首选治疗方法，应尽早开始辅助治疗。
