Primary dural lymphoma is a rare subtype of primary central nervous system lymphoma. Primary dural lymphoma may be radiologically misdiagnosed as it shares similar imaging characteristics with several pathologies, including meningiomas and subdural or epidural hematomas. We present a patient who was originally diagnosed with a subdural hematoma following a syncopal episode on computed tomography. Follow-up magnetic resonance imaging of the brain demonstrated heterogeneously enhancing dural-based mass overlying the left frontoparietal convexity associated with bidirectional dural tails, suggestive of a malignant meningioma. Neurosurgical histopathology revealed marginal zone B-cell lymphoma. This case represents the potential difficulty in diagnosing primary dural lymphoma, especially in the setting of uncertain clinical history and obscured imaging features.
Keywords: 18F-FDG PET/CT, 2-deoxy-2-[fluorine-18]fluoro-D-glucose integrated with computed tomography; ADC, Apparent diffusion coefficient; CNS, Central nervous system; CT, Computed tomography; DWI, Diffusion-weighted imaging; Dural lymphoma; ED, Emergency department; FLAIR, Fluid-attenuated inversion recovery; MR, Magnetic resonance; MZBCL, Marginal zone B-cell lymphoma; Meningioma; Neuroradiology; Neurosurgery; PCNSL, Primary central nervous system tumor; PCP, Primary care physician; PDL, Primary dural lymphoma; Radiation oncology; SPECT, single-photon emission computed tomography; Subdural hematoma.
© 2022 The Authors. Published by Elsevier Inc. on behalf of University of Washington.