原发性骨伯基特样颅骨淋巴瘤模拟脑膜瘤1例报告及文献复习

Rita Nader, E. Saad, V. Najjar, Annoir Shayya, Y. Comair, H. Ghanem
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摘要

原发性颅骨骨淋巴瘤极为罕见,临床病程和预后不一。我们正在描述一个26岁女性的病例,她出现了2年的间歇性头皮肿胀和头骨疼痛史。脑MRI显示双侧额骨增厚,下脑膜带状增厚提示带状脑膜瘤病。根据影像学检查结果,患者可能被诊断为脑膜瘤,并接受了手术切除;病理表现为b细胞淋巴瘤,特征介于弥漫性大b细胞淋巴瘤和伯基特淋巴瘤之间。PET CT扫描显示骶骨高代谢性病变,活检显示与相同的淋巴瘤特征一致。她接受了利妥昔单抗和Hyper-CVAD方案的化疗(表1),并在初次诊断后19个月持续完全缓解。文献中已经报道了几例原发性颅骨或颅顶淋巴瘤,但只发现了一例具有相同病理的伯基特样淋巴瘤。
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Primary Bone Burkitt’s like Lymphoma of the Skull Mimicking Meningioma-Case Report and Review of Literature
Primary Bone Lymphoma of the skull is extremely rare and has a variable clinical course and prognosis. We are describing a case of a 26 year old woman who presented with a 2 year history of intermittent scalp swelling and skull pain. Brain MRI showed thickening of the bilateral frontal bones and band thickening of the underlying meninges suggestive of band meningiomatosis. Patient was presumably diagnosed with a meningioma based on radiological findings and underwent resection; however, pathology was consistent with a B-cell lymphoma with features intermediate between diffuse large B-cell lymphoma and Burkitt lymphoma. A PET CT scan showed sacral bone hypermetabolic lesion which was biopsied and consistent with same lymphoma features. She received chemotherapy with Rituximab and Hyper-CVAD protocol (Table 1) and had a sustained ongoing complete remission 19 months after her initial diagnosis. Several cases of primary lymphoma of the skull or cranial vault have been described in the literature, but only one other case with the same pathology of Burkittlike lymphoma was found.
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