Cancer Res Treat.  2016 Apr;48(2):859-863. 10.4143/crt.2014.334.

Extranodal Marginal Zone B-Cell Lymphoma of Mucosa-Associated Tissue Type Involving the Dura

• Choi JY
• Chung JH
• Park YJ
• Jung GY
• Yoon TW
• Kim YJ
• Lim TK
• Kim BS
• Nam SH

• KMID: 2454367
• DOI: http://doi.org/10.4143/crt.2014.334

Abstract

Primary central nervous system marginal zone B-cell lymphoma (MZBCL) is very rare, with only a few reported cases worldwide. It has an indolent disease course with high cure potential. We experienced a rare case of dural MZBCL of mucosa-associated lymphoid tissue (MALT) in a 69-year-old man who presented with headache. A magnetic resonance imaging scan of brain showed a 1.9×3.6-cm-sized extra-axial mass with a broad based dural attachment to the anterosuperior aspect of the falx cerebri, radiographically consistent with meningioma. Surgical resection yielded a MZBCL of the MALT type. Histopathology revealed a lymphoplasmacytic infiltration of the dura, and immunohistochemical study showed a B-cell phenotype with CD20, bcl-2, MUM-1, Ki-67 positive. He was treated with chemotherapy after complete surgical resection and remained free of disease at 30 months after chemotherapy. MALT lymphoma must be considered in the differential diagnosis in patients presenting radiographically with meningioma.

Keyword

Dura mater; Marginal zone B-cell lymphoma; Central nervous system neoplasms

MeSH Terms

Aged
B-Lymphocytes
Brain
Central Nervous System
Central Nervous System Neoplasms
Diagnosis, Differential
Drug Therapy
Dura Mater
Headache
Humans
Lymphoid Tissue
Lymphoma, B-Cell, Marginal Zone*
Magnetic Resonance Imaging
Meningioma
Phenotype
Spinal Cord

Figure

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  Fig. 1. Magnetic resonance imaging of the brain. (A) T2 weighted image shows the 1.9×3.6 extra-axial mass with broad based dural attachment to anterosuperior aspect of falx cerebri involving superior sagittal sinus. (B) T1 weighted image. The mass showed dural tail sign and a suspicious cerebrospinal fluid cleft sign.

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  Fig. 2. Histological and immunohistochemical finding. (A) The central collagen band-like structure, dura mater and the tumor consisting of lymphoid tissue (H&E staining, ×40). (B) The tumor is mainly composed of monocytoid B cells having small to medium sized nuclei and abundant pale cytoplasm (H&E staining, ×400). (C, D) The tumor cells show immunoreactivity for CD20 (C) and bcl-2 (D) (×100).

Reference

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