title: Diffuse large B cell lymphoma of the cranial vault: two case reports.
abstract: Malignant lymphoma of the cranial vault is a rare entity and the tumor growth patterns are not well understood. Here we report two cases of malignant lymphoma involving the scalp and epidural space with slight changes in the intervening skull. A 63-year-old woman presented with a scalp mass in her right frontal area. Computed tomography (CT) and magnetic resonance (MR) imaging demonstrated mass lesions in the scalp and epidural space with slight osteolytic changes in the intervening skull. She underwent resection of the lesions. A 53-year-old man presented with a mass in his right frontal area. CT and MR imaging showed mass lesions in the scalp and epidural space without changes in the skull. He underwent resection of the lesions. The histopathological diagnosis was diffuse large B cell lymphoma in both cases. Microscopic examination of the intervening skull found that the bone marrow was diffusely replaced by lymphoma cells, and lymphoma cells extended to the extra- or intra-cranial space along the emissary veins without destruction of the cortical or trabecular bone. These histopathological findings explain the radiological findings and provide the clues to elucidate the mechanism of extension of cranial vault lymphoma.
authors.affiliation: Department of Neurosurgery, Sendai Medical Center, 2-8-8 Miyagino, Miyaginoku, Sendai, 983-8520, Japan.
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Tashiro
authors.affiliation: Department of Neurosurgery, Sendai Medical Center, 2-8-8 Miyagino, Miyaginoku, Sendai, 983-8520, Japan. mkanamori@med.tohoku.ac.jp.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Kanamori
authors.affiliation: Department of Pathology and Laboratory Medicine, Sendai Medical Center, Sendai, Japan.
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Suzuki
authors.affiliation: Department of Neurosurgery, Sendai Medical Center, 2-8-8 Miyagino, Miyaginoku, Sendai, 983-8520, Japan.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Utsunomiya
authors.affiliation: Department of Hematology, Sendai Medical Center, Sendai, Japan.
authors.forename: Kuniaki
authors.initials: K
authors.lastname: Meguro
authors.affiliation: Department of Neurosurgery, Sendai Medical Center, 2-8-8 Miyagino, Miyaginoku, Sendai, 983-8520, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Uenohara
authors.affiliation: Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Japan.
authors.forename: Teiji
authors.initials: T
authors.lastname: Tominaga
mesh_terms: D058846:Antibodies, Monoclonal, Murine-Derived / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage; D038524:Diffusion Magnetic Resonance Imaging; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011239:Prednisolone / Q000008:administration & dosage; D011241:Prednisone / Q000008:administration & dosage; D000069283:Rituximab; D012888:Skull Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; C571759:R-CHOP protocol; D000069283:Rituximab; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011239:Prednisolone; D011241:Prednisone
keywords: Cranial vault; Diffuse large B cell lymphoma; Pathological findings; Skull