Primary central nervous system marginal zone B-cell lymphoma of the Basal Ganglia mimicking low-grade glioma: a case report and review of the literature.
Primary central nervous system (CNS) marginal zone B-cell lymphoma (MZBL) is very rare and shows an indolent disease course with potential of being cured. It seems to originate from meningothelial cells, and the most common site of occurrence is the dura of the cerebral convexity. Primary CNS MZBL is often misdiagnosed as meningioma because of its similar tumor locations and appearances on magnetic resonance imaging (MRI). Surgery, radiation therapy, chemotherapy, and combinations of these are considered treatment modalities depending on the case. Herein, we describe an 18-year-old man who presented with acute onset of right-sided central facial nerve palsy, right-sided hemiparesis with motor power grade 4+, dizziness, and dysarthria. After an MRI scan of the brain, wherein he was first diagnosed with high-grade glioma, a biopsy sample showed that he had primary CNS MZBL arising in the left basal ganglia. He was treated with radiation therapy, which resulted in complete remission for 1 year and 10 months up to the date of this case report. It is important to diagnose primary CNS MZBL correctly because it is curable without unnecessary invasive treatment in cases of localized disease.
Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
Inkeun
I
Park
Jooryung
J
Huh
Jeong Hoon
JH
Kim
Sang-Wook
SW
Lee
Min-Hee
MH
Ryu
Yoon-Koo
YK
Kang
D000293:Adolescent; D001479:Basal Ganglia / Q000000981:diagnostic imaging / Q000473:pathology*; D016543:Central Nervous System Neoplasms / Q000175:diagnosis* / Q000503:physiopathology / Q000532:radiotherapy*; D003937:Diagnosis, Differential; D005910:Glioma / Q000175:diagnosis*; D006801:Humans; D018442:Lymphoma, B-Cell, Marginal Zone / Q000175:diagnosis* / Q000503:physiopathology / Q000532:radiotherapy*; D008297:Male; D011859:Radiography; D020127:Recovery of Function; D012074:Remission Induction