Small B-cell lymphoma presenting as diffuse dural thickening with cranial neuropathies.
The authors present a rare case of diffuse hypertrophy of the pachymeninges due to lymphomatous dural infiltration. This lymphoma arose late after orthotopic liver transplant, was Epstein-Barr virus (EBV)-negative, and arose in a setting of prior hepatitis C infection, a condition that may contribute to development of some non-Hodgkin's lymphomas. Biopsy of the dura demonstrated a small B-cell lymphoma, immunophenotypically most similar to those of mucosa-associated lymphoid tissues (MALT). Rapid expansion of the dura in this case resulted in profound hyperesthesia of the scalp, progressive blindness, deafness, and ataxia. As expected for MALT-lymphomas clinical symptoms responded well to cranial radiation.
Estevez
Miguel
M
Department of Neurology, University of Pittsburgh, PA, USA.
Chu
Charleen
C
Pless
Misha
M
D000368:Aged; D001932:Brain Neoplasms / Q000175:diagnosis* / Q000532:radiotherapy; D016371:Cranial Irradiation; D003389:Cranial Nerve Diseases / Q000473:pathology* / Q000532:radiotherapy; D004388:Dura Mater / Q000473:pathology*; D005260:Female; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000175:diagnosis* / Q000532:radiotherapy; D016031:Liver Transplantation; D008279:Magnetic Resonance Imaging