Diagnostic and Surgical Pitfalls of an Unusual Primary Central Nervous System Lymphoma

Ahmet GÜNAYDIN; Uygur ER; Ahmet ACUDUMAN; Hakan SABUNCUOĞLU; Evrim ÖZTÜRK

Issue release date: 12.11.2024

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Turkish Neurosurgery 2007 , Vol 17 , Num 2

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Diagnostic and Surgical Pitfalls of an Unusual Primary Central Nervous System Lymphoma

Ahmet GÜNAYDIN¹, Uygur ER², Ahmet ACUDUMAN³, Hakan SABUNCUOĞLU⁴, Evrim ÖZTÜRK⁵

^1,3Etlik Specialization Hospital, Neurosurgery Clinic, Ankara, Turkey
²Yıldırım Bayezit Training and Research Hospital, Second Neurosurgery Clinic, Ankara, Turkey
⁴Ufuk University, Neurosurgery Clinic Ankara, Turkey
⁵Yıldırım Bayezit Training and Research Hospital, Pathology Clinic, Ankara, Turkey BACKGROUND: Here we describe a case of PCNSL which was located peripherally as a single lesion and showed no evidence of pathological findings of lymphoma at the first biopsy.

CASE DESCRIPTION: A 56-year-old man was admitted to the hospital with a talking disorder and attention deficit. The neurological examination was normal. There was a left temporoparietal, 24x20 mm. enhanced lesion on MRI. The patient underwent a craniotomy and the lesion was excised totally. The pathological examination revealed glial tissue which showed reactive astrocyte proliferations. A month later, an MRI was performed and a recurrent tumor was seen near the first lesion's location. The second operation was performed via the same craniotomy, the tumor was excised totally and the second pathological examination revealed diffuse large-cell, B-lymphoma. There were no pathological findings on abdominal, thoracic and bone marrow investigations.

CONCLUSION: PCNSL may show various biological behaviors. Using steroids before the biopsy may lead to diagnostic and therapeutic failure. Keywords : Primary CNS Lymphoma, Craniotomy, Pathology, Spontaneous remission, Tumor regression

Corresponding author : Uygur Er, uygurer@gmail.com