Primary large B-cell lymphoma of the fourth ventricle

Chih-Hsiang Liao; Shih-Chieh Lin; Sheng-Che Hung; Sanford P C Hsu; Donald Ming-Tak Ho; Yang-Hsin Shih

doi:10.1016/j.jocn.2013.02.036

Primary large B-cell lymphoma of the fourth ventricle

J Clin Neurosci. 2014 Jan;21(1):180-3. doi: 10.1016/j.jocn.2013.02.036. Epub 2013 Sep 5.

Authors

Chih-Hsiang Liao¹, Shih-Chieh Lin², Sheng-Che Hung³, Sanford P C Hsu⁴, Donald Ming-Tak Ho², Yang-Hsin Shih⁵

Affiliations

¹ Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, 201, Section 2, Shih-Pai Road, Taipei 112, Taiwan, ROC.
² Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; National Yang Ming University School of Medicine, Taipei, Taiwan, ROC.
³ Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; National Yang Ming University School of Medicine, Taipei, Taiwan, ROC.
⁴ Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, 201, Section 2, Shih-Pai Road, Taipei 112, Taiwan, ROC; National Yang Ming University School of Medicine, Taipei, Taiwan, ROC. Electronic address: doc3339b@gmail.com.
⁵ Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, 201, Section 2, Shih-Pai Road, Taipei 112, Taiwan, ROC; National Yang Ming University School of Medicine, Taipei, Taiwan, ROC.

PMID: 24012385
DOI: 10.1016/j.jocn.2013.02.036

Abstract

We present a patient with an isolated primary central nervous system lymphoma (PCNSL) of the fourth ventricle. A 77-year-old man had a 1 week history of intermittent vertigo, nausea, vomiting, and progressively unsteady gait. CT scans of the brain showed a fourth ventricle tumor. MRI revealed a 2.5 cm dumbbell-shaped avidly-enhancing tumor in the fourth ventricle. Metastasis or high-grade glioma was suspected. The neuropathological findings were compatible with a diffuse large B-cell lymphoma. A slit lamp examination, bone marrow biopsy, and imaging studies for extracranial lesions were unremarkable. We suggest that PCNSL be listed in the differential diagnosis of fourth ventricle tumors with well-circumscribed margins and homogenous contrast enhancement.

Keywords: Central nervous system; Diffuse large-cell lymphoma; Fourth ventricle tumor; Immunocompetence; Non-Hodgkin’s lymphoma.

Publication types

Case Reports

MeSH terms

Aged
Brain Neoplasms / pathology*
Brain Neoplasms / surgery
Diffusion Magnetic Resonance Imaging
Fourth Ventricle / pathology*
Fourth Ventricle / surgery
Humans
Lymphoma, Large B-Cell, Diffuse / pathology*
Lymphoma, Large B-Cell, Diffuse / surgery
Male