Aims and objectives
1. To present and illustrate the different patterns of involvement of the cranial vaultlymphoma.
2.
To emphasise the importance of advanced magnetic resonance imaging techniques in the diagnosis ofcranial vaultlymphoma underlining the role of MRI in monitoring the response to therapy.
3.
To show the entities that most frequently pose a differential diagnosis with ofcranial vaultlymphoma.
Methods and materials
We rewiewed the last 5 years of aggressive lymphomatous lesions of the cranial vaultonour archives finding five cases.
We described and analyzed the radiological findings in CT,
MRI and PET when available.All cases were studied with diffusion sequence and only intwo cases weperformed a MR perfusion sequence .
We also rewiewed other non-lymphomatous lesions of skull to establish the differential diagnosis.
Results
Case 1
A 61-year-old-patient receiving aspirin was attended by emergency medical services for seizures and head trauma.
An emergency CT showed a right subdural mass with mass effect mimicking subdural hematoma.
The patient had no history of previous lymphoma.
MRI with contrast was performed and a diffuse thickening of the meninges due to lymphomatous dural infiltration was show (Fig.1).
Biopsy of the dura demonstrated a dural-based small B-cell lymphoma,
immunophenotypically most similar to those of mucosa-associated lymphoid tissues (MALT). After chemo and radiotherapy the patient...
Conclusion
Although initially bony changesmay be minimal,in advances cases,
typical radiographic images show a large soft tissue component of the permeative growth or a moth-eaten pattern and less cortical destruction.
On plain CT scan and MRI,
these lesions are iso-hyperdense and isointense in nature,
respectively,
withhomogeneous enhancement after contrast administration.
Hypointensity onT2 an low ADC values,when present,
are a helpuldistinguishing feature reflecting its hypercellular nature.
Bone window CT is better in assessing cortical bone involvementbut contrast MRI is superior in showing diffuse primary cutaneous invasion of...
References
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Anita Ramesh,
Muhamed Kamaludeen,
Udhaya,
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Jude J.Martin.
Primary Non-Hodgkin’s Lymphoma of the Scalp and Cranial Vault:Case Reports in Neurological Medicine Volume 2012,
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3 - Vincenzo Salvo MD,
Barbara Brogna MD,
Luigi Sampirisi MD,
Alice Casinelli MD,
Rastelli Emanuela MD.Diffuse-primary-B-cell lymphoma of the cranial vault presenting as stroke: Radiology Case Reports 13 (2018) 658–662.
4 -...