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Precursor B-lymphoblastic lymphoma mimicking: An acute subdural hematoma
Affiliations- Department of Haematology, Acıbadem Hospital, Istanbul, Turkey
- Department of Neurosurgery, Memorial Hospitals Group, Istanbul, Turkey
- Department of Pathology, Georgetown University Hospital, Washington D.C., USA
open access
Abstract
Objective and importance
We present the first case of a precursor acute subdural B-lymphoblastic lymphoma mimicking an acute subdural hematoma.
Clinical presentation
A 19 year old male presented with an acute onset of headache, nausea and vomiting. CT scan showed crescentic right-sided, frontoparietal subdural mass isointense with cortex and showing homogeneous enhancement after gadolinium.
Intervention
The patient underwent a craniotomy and a gray subdural tumor with invasion of both dura and brain was observed. The invaded dura was resected and duraplasty performed. Histopathologically, the tumor was composed of small round cells infiltrating soft tissue. In some areas of the tumor, cells were arranged in a linear, “Indian file” fashion between collagen bundles. Their nuclei were generally uniform, round to ovoid in shape, small to medium in size, and featured delicate chromatin. Accompanying cytoplasm was scant. Necrosis was absent. On immunohistochemical analysis, the tumor cells were positive for CD79a, TdT, CD10 and CD34.
Conclusion
Subdural lymphoma can present as a neurosurgical emergency, and lymphoma should be considered as a rare but possible diagnosis before operation.
Abstract
Objective and importance
We present the first case of a precursor acute subdural B-lymphoblastic lymphoma mimicking an acute subdural hematoma.
Clinical presentation
A 19 year old male presented with an acute onset of headache, nausea and vomiting. CT scan showed crescentic right-sided, frontoparietal subdural mass isointense with cortex and showing homogeneous enhancement after gadolinium.
Intervention
The patient underwent a craniotomy and a gray subdural tumor with invasion of both dura and brain was observed. The invaded dura was resected and duraplasty performed. Histopathologically, the tumor was composed of small round cells infiltrating soft tissue. In some areas of the tumor, cells were arranged in a linear, “Indian file” fashion between collagen bundles. Their nuclei were generally uniform, round to ovoid in shape, small to medium in size, and featured delicate chromatin. Accompanying cytoplasm was scant. Necrosis was absent. On immunohistochemical analysis, the tumor cells were positive for CD79a, TdT, CD10 and CD34.
Conclusion
Subdural lymphoma can present as a neurosurgical emergency, and lymphoma should be considered as a rare but possible diagnosis before operation.
Keywords
Lymphoblastic; Lymphoma; Subdural; Hematoma
About this articleTitle
Precursor B-lymphoblastic lymphoma mimicking: An acute subdural hematoma
Journal
Issue
Pages
258-262
Published online
2016-10-01
DOI
10.1016/j.achaem.2016.10.003
Bibliographic record
Acta Haematol Pol 2016;47(4):258-262.
Keywords
Lymphoblastic
Lymphoma
Subdural
Hematoma
Authors
Ant Uzay
Siret Ratip
Ilhan Elmaci
Metin Ozdemirli