Imaging characteristics of diffuse primary cutaneous B-cell lymphoma of the cranial vault with orbital and brain invasion

Abstract

We herein present the imaging findings in a case of diffuse primary cutaneous B-cell lymphoma of the cranial vault with orbital and brain invasion. MR imaging revealed first concomitant orbital and parenchymal invasion in a case of primary diffuse non-Hodgkin lymphoma of the cranial vault. Contrast-enhanced MR imaging revealed a diffuse mass in the scalp of the frontoparietal region bilaterally and invasion of the right orbit and left frontoparietal lobe. Histologic and immunopathologic examinations revealed diffuse primary cutaneous B-cell lymphoma.

Fig 1.

Images of a 65-year-old man who presented with a 6-month history of a right frontoparietal nodule that included ulcers and a 1-month history of swelling on the right lid. A, Unenhanced sagittal T1-weighted MR image does not show any cranial invasion. B, Contrast-enhanced sagittal T1-weighted MR image shows strong enhancement of a diffuse mass in the scalp bilateral frontoparietal region and invasion of the dura and left gyrus frontalis medius. C, Coronal view T2-weighted image shows isointense lesion and peripheral hyperintense edema on the left medial frontal gyrus. D, Sagittal T2-weighted image shows hyperintense edema on the frontal lobe. E, Contrast-enhanced coronal T1-weighted image shows marked enhancement at the right lateral orbital wall and muscle rectus lateralis. F, Axial fluid-attenuated inversion recovery image shows invasion of orbital wall (arrow) and muscle (arrowheads). G, Photomicrograph of a specimen shows tumoral cells (stars) in stratified squamous epithelium (arrows) (hematoxylin and eosin; original magnification, ×200). H, Photomicrograph shows CD20-positive tumoral cells (arrowheads) (strep ABC; original magnification, ×100) and stratified squamous epithelium (arrows).