Primary central nervous system lymphoma at the cerebellopontine angle mimicking a trigeminal schwannoma: A unique case report and literature review

Primary Central Nervous System Lymphoma of the Cerebellopontine Angle: Epidemiological Characteristics and Imaging Features May Be Helpful for Making an Accurate Preoperative Diagnosis

“…Characteristic T2-wighted MRI may play an important role in the preoperative differential diagnosis [7][8][9]. In the present study, we found that 68.4% of all the CPA PCNSLs appeared as isointense to hypointense on T2WI, which is in contrast to most other CPA lesions [24,38]. This signal intensity is attributable to the high cellularity and high nuclear to cytoplasmic ratio of the PCNSL, which also correspondingly explains the high signal intensity of PCNSLs usually observed on diffusion-weighted imaging (DWI) [13,24].…”

“…Primary central nervous system lymphoma is a rare and aggressive extranodal non-Hodgkin lymphoma that restricted entirely to the brain, leptomeninges, spinal cord or eyes, without systemic involvement [9,29]. PCNSL accounts for approximately 1-4% of all primary brain tumors [2,24], but its incidence has been increasing over the past 20 years in both immunocompetent and immunocompromised individuals [10,12]. Diffuse large B-Cell Lymphomas are the most common type (~ 90%), while the remaining 10% are poorly characterized by Burkitt's lymphomas, T-Cell lymphomas and low-grade lymphomas [29][30][31][32].…”

“…PCNSLs of the CPA typically present with trigeminal, facial, audiovestibular and cerebellar dysfunction, including hearing loss, tinnitus, facial palsy, vertigo and ataxia [7,10,14,29]. Other neurological symptoms include headache, nausea, vomiting, hoarseness and nystagmus [18,23,24].…”

“…Given that CPA PCNSLs can be very non-speci c with the presenting symptoms, accurate preoperative diagnosis of the lesion is mainly based upon imaging. On computed tomography (CT) scan, PCNSLs of the CPA generally present as hyperdense lesions with homogenous enhancement after contrast administration [9,21,24,30]. Bony erosion and expansion of the internal auditory canal is rare in the PCNSL of CPA, which can be differentiate from acoustic neurinoma [9].…”

“…In the present study, we found that 80.0% of all the CPA PCNSLs presented as hyperdense lesions on CT scans. On MRI, PCNSLs of the CPA are typically homogeneously isointense on T1WI [7,12,14], and homogeneously isointense/hypointense with mild perifocal edema on T2WI [8,9,24]. After contrast administration, they show an intense homogeneous enhancement [21,34].…”