Intracranial Marginal Zone B-Cell Lymphoma Mimicking Meningioma

Background Marginal zone B-cell lymphoma of the meninges is a rare pathologic subtype of central nervous system lymphoma that can mimic the radiologic appearance of meningioma. Case Description We present a unique case of a 57-year-old man who presented with neurologic symptoms of severe headache, m...

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Published inWorld neurosurgery Vol. 91; pp. 676.e9 - 676.e12
Main Authors Douleh, Diana G, Morone, Peter J, Forbes, Jonathan A, Thompson, Reid C
Format Journal Article
LanguageEnglish
Published United States Elsevier Inc 01.07.2016
Subjects
Craniotomy
Humans
Intracranial
Lymphoma
Lymphoma, B-Cell, Marginal Zone - diagnostic imaging
Lymphoma, B-Cell, Marginal Zone - physiopathology
Magnetic Resonance Imaging
Male
Meningeal Neoplasms - diagnostic imaging
Meningeal Neoplasms - physiopathology
Meningioma
Meningioma - diagnostic imaging
Meningioma - physiopathology
Middle Aged
Neurosurgery
Spectroscopy
Intracranial
Spectroscopy
MRI
Central nervous system
CNS
Primary central nervous system lymphoma
Lymphoma
N-acetylaspartate
MRS
NAA
Magnetic resonance spectroscopy
CT
PCNSL
Computed tomography
Magnetic resonance imaging
Craniotomy
Meningioma
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Summary:Background Marginal zone B-cell lymphoma of the meninges is a rare pathologic subtype of central nervous system lymphoma that can mimic the radiologic appearance of meningioma. Case Description We present a unique case of a 57-year-old man who presented with neurologic symptoms of severe headache, memory loss, mental status changes, and depression. Subsequent magnetic resonance imaging of the brain demonstrated an enhancing mass tracking along the anterior falx and anterior skull base with extension into the ethmoid sinus, which was radiographically consistent with meningioma. However, pathologic examination revealed numerous sheets of plasma cells and plasmacytoid lymphocytes that were immunopositive for CD20. These combined features were indicative of marginal zone B-cell lymphoma. No evidence of systemic disease was found. Conclusions Although rare, marginal zone B-cell lymphoma must be considered in the differential diagnosis of an extra-axial enhancing mass. We review the contemporary literature and discuss preoperative radiologic differentiation of these 2 very different histopathologies.
Bibliography:ObjectType-Case Study-2
SourceType-Scholarly Journals-1
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ISSN:1878-8750
1878-8769
DOI:10.1016/j.wneu.2016.04.106