Primary dural high grade B cell lymphoma mimicking subdural hematoma

Case

A 78-year-old woman came to the hospital because of headache and tumefaction of the right temporal area. There were no other neurological symptoms. Cranial magnetic resonance imaging (MRI) showed a low-density area underneath the osseous inner plate, simulating a subdural hematoma (Figure 1). The histopathological analysis revealed neoplastic proliferation of large lymphoid cells with pleomorphic nuclei. Upon immunostaining, neoplastic cells were positive for CD79a, CD10, BCL6 and C-MYC and were negative for CD3 and CD5 (Figure 2). The proliferation index (Ki67) was 55%. The diagnosis of primary dural large B-cell lymphoma was established. Such a presentation of aggressive lymphoma is extremely unusual.¹,²

Figure 1
MRI showing a hypointense subdural lesion in the right temporoparietal region (arrow) on a T1-weighted sequence.

Figure 2
Neoplastic cells. (a). Hematoxylin & eosin stain (400×). (b). Immunostaining for BCL-2 (400×). (c). Immunostaining for BCL-6 (400×). (d). Immunostaining for C-MYC (400×).

REFERENCES

• ¹
  Vemuri NV1, Karanam LS, Rambabu L, Rao VS, Kalyan K, Sateesh G. Subdural B Cell Lymphoma Imaging features Histopathology. Literature review. Neuroradiol J. 2013;26(6):636-8.
• ²
  Fuente MI, Haggiagi A, Moul A, Young RJ, Sidani C, Markoe A, et al. Marginal zone dural lymphoma: the Memorial Sloan Kettering Cancer Center and University of Miami Experiences. Leuk Lymphoma. 2017;58(4):882-8.

Publication Dates

• Publication in this collection
  29 Nov 2021
• Date of issue
  2021

History

• Received
  05 Nov 2019
• Accepted
  08 Jan 2020
• Published
  20 Mar 2020