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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.
Figures and Tables
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
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