Primary central nervous system lymphoma (PCNSL) mimicking a falx meningioma with increasingly massive intracerebral hemorrhage

When using imaging to diagnose brain tumors, it is important to determine whether the tumor is intra- or extra-parenchymal. An 80-year-old man was found on magnetic resonance imaging to have an enhanced mass that appeared to be in the falx and a massive hematoma in the left frontal lobe; the provisi...

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Bibliographic Details
Published inRadiology case reports Vol. 18; no. 4; pp. 1514 - 1517
Main Authors Tomita, Yusuke, Iwamoto, Naotaka, Hayashi, Takaki, Takahashi, Mikiko, Yamada, Shoko Merrit
Format Journal Article
LanguageEnglish
Published Netherlands Elsevier Inc 01.04.2023
Elsevier
Subjects
Case Report
Enhancement
Falx
Intracerebral hemorrhage
Intraparenchymal
Malignant lymphoma
Intraparenchymal
Malignant lymphoma
Enhancement
Falx
Intracerebral hemorrhage
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Summary:When using imaging to diagnose brain tumors, it is important to determine whether the tumor is intra- or extra-parenchymal. An 80-year-old man was found on magnetic resonance imaging to have an enhanced mass that appeared to be in the falx and a massive hematoma in the left frontal lobe; the provisional diagnosis was falx meningioma. However, the tumor and hematoma were found intraoperatively to be completely intraparenchymal. Additionally, the falx was intact and not adherent to brain tissue. Malignant lymphoma was diagnosed histologically on the basis of abnormal proliferation of atypical CD20-positive lymphocytes. Cerebral hemorrhage is an extremely rare presentation of primary central nervous system lymphoma. To the best of our knowledge, only 7 cases have been reported. All the reported cases had enhancement in the hematoma; however, in our case, there was definite enhancement outside the hematoma, making the correct diagnosis of lymphoma difficult.
ISSN:1930-0433
1930-0433
DOI:10.1016/j.radcr.2023.01.008