J Korean Soc Radiol.  2014 Oct;71(4):160-163. 10.3348/jksr.2014.71.4.160.

Dural Anaplastic Large Cell Lymphoma Mimicking Meningioma: A Case Report

• Kim KH
• Kim KH
• Lee GJ
• Lee CH
• Lee HK
• Shim JC
• Lee KE
• Kim HK
• Suh JH

• KMID: 2097998
• DOI: http://doi.org/10.3348/jksr.2014.71.4.160

Abstract

Anaplastic large cell lymphoma (ALCL) is a rare T cell lymphoma composed of CD30-positive lymphoid cells. Most ALCLs present as nodal disease, with skin, bone, soft tissue, lung, and liver as common extranodal sites. ALCL rarely occurs in the central nervous system and is even more infrequent in the dura of the brain. We report a case of dural-based ALCL secondary to systemic disease in a 17-year-old male that mimicked meningioma on magnetic resonance imaging and angiography.

MeSH Terms

Adolescent
Angiography
Brain
Central Nervous System
Humans
Liver
Lung
Lymphocytes
Lymphoma
Lymphoma, Large-Cell, Anaplastic*
Lymphoma, T-Cell
Magnetic Resonance Imaging
Male
Meningioma*
Skin

Figure

• 

  Fig. 1 Radiologic findings of dural anaplastic large cell lymphoma in a 17-year-old man. A. Precontrast axial CT shows homogenous broad dural-based semi-ovoid extra-axial mass in the left temporal lobe. B, C. On T1-weighted (B) and T2-weighted (C) MR images, a heterogeneous broad dural-based extra-axial mass in the left temporal lobe has similar signal intensity as parenchymal gray matter. D. Gadolinium-enhanced coronal T1-weighted MR images show intense and homogenous enhancement of the mass with dural-tail sign. E, F. Left external carotid artery angiogram demonstrates a prominent core vascular supply with a sunburst appearance supplied by the middle meningeal artery in the arterial phase (E) and prolonged vascular stain in the late venous phase (F).

• 

  Fig. 2 Microscopic findings of dural anaplastic large cell lymphoma in a 17-year-old man. A. Histopathologic examination under high power shows a diffuse population of large, atypical lymphoid cells with abundant cytoplasm; round and pleomorphic nuclei; and prominent nucleoli (H&E, × 200). B. Immunohistological examination under high power shows that tumor cells are immunoreactive for CD30 (immunoperoxidase, × 400).

• 

  Fig. 3 Systemic involvement of dural anaplastic large cell lymphoma in a 17-year-old man. A. Axial portal phase CT image reveals multiple enlarged and conglomerated mesenteric lymph nodes (arrows). B. Positron emission tomography image reveals multiple areas of hot uptake such as mesenteric and pelvic lymph nodes and bones of the upper and lower extremities.

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