Primary CNS anaplastic diffuse large B-cell lymphoma mimicking undifferentiated metastatic tumors: a case report.
Primary central nervous system lymphoma (PCNSL) is a rare intracranial tumor, with an annual incidence of six per million population. Anaplastic variant of primary CNS diffuse large B-cell lymphoma is less common; to our knowledge, there is only one other case report in the world literature. We describe a 71 year old immunocompetent female without significant past medical history who presented with confusion and a homogeneously enhancing midline mass. The patient underwent craniotomy for tumor biopsy, followed by high-dose methotrexate-based chemotherapy despite a remarkably low performance status. Histologically, this tumor was composed of undifferentiated polymorphic tumor cells, multi-nucleated giant cells, extensive necrosis, and conspicuous mitotic activity, mimicking undifferentiated metastatic tumors. Immunohistochemical stains demonstrated immunopositivity of tumor cells for CD20, MUM-1, and BCL-6, and negative staining for CD3, CD10, and CD30. The clinical course, diagnostic workup, pathologic correlates, and treatment outcomes are described.
Yang
Tianyu
T
Department of Pathology and Lab Medicine, North Shore University Hospital-Long Island Jewish Medical Center, 300 Community Drive, Manhasset, NY 11030, USA.
Belverud
Shawn
S
Yeh
Albert Y
AY
Bandovic
Jela
J
Farmer
Peter
P
Woldenberg
Rona F
RF
Demopoulos
Alexis
A
Schulder
Michael
M
Li
Jian Yi
JY
D000368:Aged; D016543:Central Nervous System Neoplasms / Q000175:diagnosis*; D005260:Female; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging / Q000379:methods