Primary low-grade B-cell lymphoma of mucosa-associated lymphoid tissue of the dura mimicking the presentation of an acute subdural hematoma

Abstract

The authors present the case of a 64-year-old woman who experienced a left hemiparesis. An initial diagnosis of subdural hematoma was made based on results of computerized tomography scanning. Subsequent magnetic resonance imaging indicated an extraaxial meningioma. Histological findings confirmed an extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT). The authors outline the natural history of central nervous system lymphomas and of MALT lymphomas in other tissues. They review seven previously reported cases and emphasize the importance of recognizing these tumors as a distinct clinicopathological entity.

Marginal zone lymphomas involving meningeal dura: possible link to IgG4-related diseases

“…The latter presentation has been reported previously in dural marginal zone lymphoma. 33,39 Irrespective of the treatment modalities (radiation, chemotherapy or combined modality) used in our study, complete remission was achieved in most patients with no evidence of recurrence.…”

“…5 Since our original report, several other publications have confirmed a small risk for MALT lymphoma in this site. 7,[32][33][34][35][36][37][38] Among lymphomas primary to the dura, marginal zone lymphoma is reportedly the most common type. However, these cases are still relatively rare and with limited data regarding their clinical behavior.…”

Primary Central Nervous System Mucosa-Associated Lymphoid Tissue Lymphoma-Case Report-

“…18) Only small numbers of CNS MALT lymphomas have been reported. 2,6,7,[11][12][13][15][16][17][18][19]21,22,[24][25][26][27][28]31,33) Most cases of CNS MALT lymphomas occur in middle-aged women in contrast to primary CNS lymphoma which has a slight male predilection, although no specific factors related to sex have been identified. Most patients with CNS MALT lymphoma in the cranium present with insidious onset of headaches, seizure, focal sensory disturbances, and CT/MR imaging findings of well-defined, intracranial, dural masses, which are diagnosed clinically as meningioma.…”

“…MALT lymphoma originating from meningeal tissue is rare, and only a handful of cases and small series have been described. 2,6,7,[11][12][13][15][16][17][18][19]21,22,[24][25][26][27][28]31,33) This subtype is distinct from other primary CNS lymphoma or metastatic CNS lymphoma that can have poor outcomes. Therefore, recognition of this rare subtype of CNS lymphoma is important.…”

Management of neurotropic low‐grade B‐cell lymphoma: Report of two cases

“…Radiation was an important part of the treatment. [5][6][7] The two cases discussed here had evidence of a low-grade neoplasm: small cell size, low S-phase fraction by flow cytometry, and indolent clinical behavior, despite the aggressive appearance of this tumor on imaging studies. To our knowledge, this is the first report showing a neurotropic extranodal and nonmucosal marginal zone lymphoma with both intracranial and extracranial involvement.…”