J Korean Soc Radiol.  2012 Nov;67(5):319-322. 10.3348/jksr.2012.67.5.319.

Primary Cranial Vault Lymphoma: A Case Report

• Yoon S
• Kim MS
• Kim YJ

• KMID: 1819746
• DOI: http://doi.org/10.3348/jksr.2012.67.5.319

Abstract

Cranial vault involvement in primary lymphoma is extremely rare in immunocompetent subjects. However, it should be considered as a differential diagnosis in the presence of a lesion involving all three compartments of the cranial vault, including the scalp, skull, and pachymeninges. We report a case of primary cranial vault lymphoma involving all three compartments of the cranial vault in an immunocompetent patient.

MeSH Terms

Diagnosis, Differential
Humans
Lymphoma
Scalp
Skull

Figure

• 

  Fig. 1 A 72-year-old woman with a palpable skull mass. A. Anteroposterior view of the skull reveals a 4.3 × 3.4 cm ill-defined osteolytic lesion without sclerotic rim (arrows). B, C. Axial CT scan of the brain with brain (B) and bone window (C) images shows a 5.9 × 2.3 cm inhomogeneous intracranial and extracranial mass with mixed density, in addition to moth-eaten bone destruction in the right parietal skull vault (arrows). D-H. Axial T1 weighted (D), T2 weighted (E) and FLAIR images (F) of the MRI of the brain show a 5.6 × 2.3 cm relatively homogeneous isointense mass involving the scalp, skull and pachymeninges at the right parietal region (arrows). Adjacent brain parenchyma shows normal appearance. The lesion also shows restricted diffusion on DWI (G) and inhomogeneous enhancement (H) on contrast enhanced image (arrows). I, J. Photomicrographs of the surgical specimen show diffuse proliferation of cells with loss of cohesiveness in the hematoxylin-eosin stain (I, × 100) and strong staining of tumor cells for CD20 (J, × 100). Note.-DWI = diffusion-weighted imaging, FLAIR = fluid attenuated inversion recovery

Reference

1. Baleydier F, Galambrun C, Manel AM, Guibaud L, Nicolino M, Bertrand Y. Primary lymphoma of the pituitary stalk in an immunocompetent 9-year-old child. Med Pediatr Oncol. 2001. 36:392–395.

2. Bhatia S, Smally AJ, Dekker P. Primary non-Hodgkin's lymphoma of the cranial vault. Clin Oncol (R Coll Radiol). 1997. 9:195–196.

3. Ford DR, Wilson D, Sothi S, Grimer R, Spooner D. Primary bone lymphoma--treatment and outcome. Clin Oncol (R Coll Radiol). 2007. 19:50–55.

4. Coley BL, Higinbotham NL, Groesbeck HP. Primary reticulum-cell sarcoma of bone; summary of 37 cases. Radiology. 1950. 55:641–658.

5. da Rocha AJ, da Rocha TM, da Silva CJ, Paes RP, Bruniera P, Chiattone CS. Cranial vault lymphoma: a systematic review of five patients. J Neurooncol. 2010. 100:9–15.

6. Jamjoom AB, Jamjoom ZA, Naim-Ur-Rahman , Cheema MA. Primary midline cranial vault lymphoma simulating a parasagittal meningioma: the role of angiography in preoperative diagnosis. Neurosurg Rev. 1998. 21:202–205.

7. Yoon SH, Paek SH, Park SH, Kim DG, Jung HW. Non-Hodgkin lymphoma of the cranial vault with retrobulbar metastasis mimicking a subacute subdural hematoma: case report. J Neurosurg. 2008. 108:1018–1020.

8. Holtås S, Monajati A, Utz R. Computed tomography of malignant lymphoma involving the skull. J Comput Assist Tomogr. 1985. 9:725–727.

9. Ochiai H, Kawano H, Miyaoka R, Kawano N, Shimao Y, Kawasaki K. Primary diffuse large B-cell lymphomas of the temporoparietal dura mater and scalp without intervening skull bone invasion. Neurol Med Chir (Tokyo). 2010. 50:595–598.

10. Sato M, Saito T, Yamaguchi K. [Primary malignant lymphoma of the skull presenting a huge mass lesion: case report]. No Shinkei Geka. 1993. 21:1061–1064.