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A Case of Primary Dural Lymphoma of Jugular Tubercle Mimicking Lower Clival Meningioma Kazunori KIHARA 1 , Motoki SATO 1 , Ken KADO 2 , Kazumasa FUKUDA 1 , Takao NAKAMURA 1 , Iwao YAMAKAMI 2 , Yasuo IWADATE 3 1Department of Neurosurgery, Chiba Central Medical Center 2Department of Neurosurgery, Chiba Medical Center 3Department of Neurosurgery, Chiba University Hospital Keyword: central nervous system lymphoma , meningioma , skull base surgery pp.391-396
Published Date 2016/5/10
DOI https://doi.org/10.11477/mf.1436203297
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 Primary dural lymphoma(PDL)is a rare type of primary central nervous system lymphoma(PCNSL);however, its clinical etiology and appearance on magnetic resonance images(MRI)are similar to those of meningioma. We report a case of PDL mimicking a meningioma in the jugular tubercle, with hemiparesis and double vision, and review the published PDL case reports.

 A 41-year-old woman experienced numbness on her right side, and reported right hemiparesis and double vision 2 days thereafter. Her cranial computed tomography(CT)scan showed a mass lesion in the posterior fossa, and contrasted MRI revealed homogenous tumor with a dural tail sign in the left jugular tubercle. The patient was diagnosed as having jugular tubercle meningioma. However, her symptoms disappeared promptly with the injection of dexamethasone, and follow-up MRI showed that the tumor had diminished. After 9 months, her double vision recurred and MRI results indicated tumor regrowth. She underwent sub-total resection of the tumor via the left trans-condylar fossa approach. A histological diagnosis was PDL. She was treated with 3 courses of high-dose methotrexate, and subsequent MRI results showed a partial reduction of the residual tumor.

 PDL is histologically associated with marginal zone lymphoma(MZL), and is sensitive to radiation and chemotherapy. This patient responded well to high-dose methotrexate alone. PDL is one of the important differential diagnoses of meningioma.


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電子版ISSN 1882-1251 印刷版ISSN 0301-2603 医学書院

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