Intracranial Cell Lymphomas That Mimic Meningiomas: Case Report To Understand Complex Genetic, Radiologic, and Histopathologic Entities

World Neurosurg. 2019 May:125:339-342. doi: 10.1016/j.wneu.2019.01.298. Epub 2019 Feb 22.

Abstract

Background: We describe a patient affected by a T-cell primary central nervous system lymphoma (PCNSL) with highly aberrant specific B-cell markers (CD79a and CD20). An unusual imaging presentation leads us to misdiagnose this lesion for a meningioma and perform surgical resection.

Case description: We think that this infrequent anatomic presentation might be due to the aberrant specific B-cell markers (CD79a and CD20) genotype expression. We believe this case to be relevant in order to appreciate the diagnosis of cerebral lymphomas according to various presentations. We wonder whether it was not the aberrant genotype that contributed to this quirky presentation and ultimately if surgery in PCNSL should not be discussed?

Conclusions: Furthermore, this case calls attention to the complexity of lineage assignment, imaging diagnosis, and treatment strategy in PCNSL.

Keywords: Brain tumor; Meningiomas; Primary central nervous system T-cell lymphomas; Surgery.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Antigens, CD20 / metabolism
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Biomarkers, Tumor / metabolism
  • CD79 Antigens / metabolism
  • Central Nervous System Neoplasms / diagnosis*
  • Central Nervous System Neoplasms / drug therapy
  • Central Nervous System Neoplasms / surgery
  • Diagnosis, Differential
  • Diagnostic Errors
  • Female
  • Humans
  • Lymphoma, T-Cell / diagnosis*
  • Lymphoma, T-Cell / drug therapy
  • Lymphoma, T-Cell / surgery
  • Magnetic Resonance Imaging
  • Meningeal Neoplasms / diagnosis
  • Meningeal Neoplasms / surgery
  • Meningioma / diagnosis*
  • Meningioma / surgery
  • Multimodal Imaging
  • Positron-Emission Tomography
  • Tomography, X-Ray Computed

Substances

  • Antigens, CD20
  • Biomarkers, Tumor
  • CD79 Antigens