Low-grade follicular lymphoma in the dura: rare mimic of meningioma.
Lymphomas rarely present as a localized mass within the dura. We report a case of a 72-year-old woman, normally fit and well, who presented with a sudden episode of grand mal seizure. Imaging studies showed an extra-axial mass arising from the dura, with radiologic features characteristic of a meningioma. The mass was surgically excised, and the histologic features were of a grade 1 follicular lymphoma. Analysis using fluorescent in situ hybridization (FISH) demonstrated t(14:18) translocation. A bone marrow aspirate showed focal infiltration of lumbar vertebra by low-grade follicular lymphoma. Intracranial meningeal involvement by non-Hodgkin lymphoma usually occurs in the form of diffuse leptomeningeal spread. It is seen in high-grade lymphomas, often in association with widespread systemic disease. The majority of cases of dural lymphomas reported in the literature have been primary mucosa-associated lymphoid tissue (MALT)-type lymphomas. Most of these presented as localized dural masses mimicking meningiomas. Low-grade follicular lymphoma, either primary or secondarily involving the dura, appears to be an exceedingly rare occurrence.
Low
Irene
I
Department of Anatomical Pathology, Auckland City Hospital, Auckland, New Zealand. irenel@adhb.govt.nz
Allen
Jonathan
J
D000368:Aged; D002883:Chromosomes, Human, Pair 14; D002887:Chromosomes, Human, Pair 18; D003937:Diagnosis, Differential; D004388:Dura Mater / Q000473:pathology*; D005260:Female; D006801:Humans; D008224:Lymphoma, Follicular / Q000235:genetics / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008577:Meningeal Neoplasms / Q000235:genetics / Q000473:pathology*; D008579:Meningioma / Q000473:pathology*; D014178:Translocation, Genetic