Diagnostic Difficulties and Management of Childhood Lymphoma: A Case Report

Primary dural lymphoma is a rare pathology, it is part of the malignant lymphoma of the central nervous system and it can reach the extradural or subdural space. We report a case of a little boy of three years and two months admitted to the Department of Neurosurgery CHU JRA for multiple swellings in the scalp associated with an altered general condition. The CT scan revealed a multiple extra-axial expansive process with retro-orbital extension responsible for an important exophthalmos as well as at the scalp level. Anatomopathological examination of the dura mater biopsy revealed a malignant non-Hodgkin's small cell lymphoma. The patient underwent chemotherapy of 05 sessions and the evolution was marked by the persistence of the symptoms. The post chemotherapy brain scan showed considerable extension of the lesions. The next step would be radiotherapy.

Primary Dural Lymphoma Mimicking En Plaque Cerebellopontine Angle Meningioma

Primary dural lymphoma (PDL) usually arises from the calvarial dura without the brain parenchyma or systemic involvement and thus may not be considered as a typical form of primary CNS lymphoma (PCNSL). It is exceedingly rare. When it occurs, it might not be suspected as a primary diagnosis on clinical and radiologic findings. We present a PDL case that occurs at the cerebellopontine (CP) angle mimicking en plaque meningioma. The tumor histopathology showed a lymphoproliferative disorder immunophenotypically consistent with a low-grade marginal zone lymphoma. Bone marrow and systemic involvements were not identified, and a diagnosis of PDL was established. As a residual tumor at the CP angle was inaccessible to surgery, postoperative radiation therapy was performed. No recurrence was found at 15-month follow-up. PDLs are mostly indolent and have a good prognosis. There is no doubt that the most important differential diagnosis is meningioma. Furthermore, the present case emphasizes the necessity of an intraoperative consultation and knowledge of this rare yet essential form of PCNSL so that appropriate studies can be ordered.

Primary Dural Lymphoma: Clinical Cases and Literature Review

Primary dural lymphoma (PDL) is an extranodal non-Hodgkin lymphoma that accounts for less than 1% of all central nervous system lymphomas. Primary dural lymphoma grows from the dura mater, and it is often diagnosed as meningioma or acute subdural hematoma due to its radiological characteristics. Surgery is the gold standard of therapy; in many patients, PDL is relatively benign with good outcome. Authors report their experience in three patients affected by extranodal non-Hodgkin lymphoma (PDL) mimicking a meningioma.