原发性中枢神经系统淋巴瘤误诊为凸性脑膜瘤1例

J. Choi, W. Yoon, Jong Hyun Kim, T. Kwon, J. Byun
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摘要

我们报告一例56岁女性患者,表现为头痛、恶心和呕吐。磁共振成像(MRI)显示左侧额叶均匀增强肿块。基于凸性脑膜瘤的印象,我们计划手术治疗,并静脉注射类固醇以减轻脑水肿。手术前进行了额外的脑部MRI以进行术中导航,显示肿瘤大小显着减小。由于静脉注射类固醇反应良好,我们怀疑肿瘤可能是另一种病变而不是脑膜瘤,因此,我们进行手术进行组织学诊断。术中发现一个白灰色的橡胶状肿瘤附着在硬脑膜和蛛网膜上,已被切除,术中冷冻活检报告淋巴瘤。最后,患者被诊断为弥漫性大b细胞淋巴瘤。本病例报告强调了考虑可能对类固醇有反应的病变和淋巴瘤的影像学特征的重要性,淋巴瘤可以与其他病变区分开来。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Primary central nervous system lymphoma misdiagnosed as convexity meningioma: A case report
We are reporting the case of a 56-year-old female patient who presented with headache, nausea, and vomiting. Magnetic resonance imaging (MRI) revealed a homogeneous enhancing mass on the left frontal lobe. Based on the impression of a convexity meningioma, surgical treatment was planned, and intravenous (IV) steroids were administered to alleviate brain edema. Additional brain MRI was performed just before surgery for intraoperative navigation, which showed a significant reduction in tumor size. Due to the good response to IV steroids, we suspected that the tumor might be a differ-ent lesion rather than a meningioma, and thus, we proceeded with surgery for histologic diagnosis. Intraoperative findings revealed a whitish-gray, rubbery tumor adhering to the dura and arachnoid membrane, which was removed, and intraoperative frozen biopsy reported lymphoma. Finally, the patient was diagnosed with diffuse large B-cell lymphoma. This case report highlights the impor-tance of considering lesions that may be responsive to steroids and the imaging characteristics of lymphoma, which can be distinguished from other lesions.
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