Cranial vault lymphoma: a systematic review of five patients

Abstract

Bone involvement is a common finding in many types of lymphoma (Clin Oncol 9(3): 195-196, 1997). However, cranial vault affliction has been regarded as an exceedingly rare presentation, particularly in the case of primary lymphoma (J Neurosurg 108(5): 1018-1020, 2008). Our objective is to describe a series of five immunocompetent patients with histologically confirmed cranial vault lymphoma (CVL), and to conduct a systematic review of the current literature. Our review points out identical imaging patterns in most of the lesions for all reported CVL cases, despite their different histological subtypes. This typical pattern can be seen on computed tomography (CT) scans and magnetic resonance imaging (MRI) as an expansive tumor that affects all three compartments of the cranial vault, including the scalp, skull bone, and pachymeninges, even in the absence of osteolysis. We argue that the absence of osteolysis might enhance diagnostic capability. In the appropriate clinical setting, these features represent important disease characteristics that may help with an earlier diagnosis. Large B-cell lymphoma was the most common subtype of primary CVL.

Skull base non-Hodgkin’s lymphoma

“…4 Clinical picture of patients with primary skull base lymphoma has been shown to be similar to intracranial infection with multiple cranial nerve palsies, extradural abscesses with osteomyelitis. 5,6 This stays true to our case as she had multiple cranial nerve palsies and presented with features of intracranial infection with radiological images suggesting skull base osteomyelitis.…”

Modern techniques of magnetic resonance in the evaluation of primary central nervous system lymphoma: contributions to the diagnosis and differential diagnosis

“…However, this pattern of lesion is not specific to PCNSL because it has been observed in systemic lymphoma and in many mimic lesions, including metastatic infiltration from prostate carcinoma and breast cancer, osteomyelitis, meningioma, plasma cell tumors, and histiocytosis. 29 …”

A 60-Year-Old Indian Male With Altered Sensorium and Extensive Lymphoma of the Scalp

“…14,41 There is no clear “best approach” in the literature, since many patients have done well with only a biopsy, while others have had more aggressive surgical resections. 16,25,39,40,42,43 In general, the more extensive surgical resections were used in patients with widespread disease, in which the scalp, bones of the cranial vault, leptomeninges, and underlying brain were all affected. The neurosurgical procedure will provide tissue for the definitive diagnosis of NHL and immunophenotyping, and may also substantially lower the tumor burden for subsequent chemotherapy and radiation.…”