Head trauma complicated with primary cranial vault lymphoma: A case report

Abstract

Rationale: Primary cranial vault lymphoma (PCVL) is an extremely rare extranodal lymphoma in the skull. This case study investigates the clinical features, so as to improve the understanding of the diagnosis and therapy.

Patient concerns: A 31-year-old male presented painful scalp mass at the site of 1-month-old head trauma.

Diagnosis: The final diagnosis was plasma cell lymphoma, which is a rare subtype of diffuse large B-cell lymphoma based on biopsy and immunohistochemistry findings.

Interventions: The patient received total tumor resection in combination with chemotherapy OUTCOMES:: The patient survived without signs of systemic dissemination for 12 months after surgery at the time of last follow-up.

Lessons: Trauma may be one of the factors that induce PCVL. The final diagnosis of PCVL depends on pathology and immunohistochemistry findings. A combined treatment of surgery, chemotherapy, and radiotherapy can achieve favorable outcomes.

Figure 1

(A–D) A non-enhanced MRI scan revealing a solid mass on the right parietal occipital bone area with osteolytic erosion and intracranial and extracranial involvement. The mass was homogenous isointense on T₁WI (A) and T₂WI (B); and slight hyperintense on DWI (C) and hypointense on ADC map (D). (E) The mass was enhanced heterogeneously and a dural tail was seen. The neighboring brain tissue was compressed. (F) SWI showed no bleeding signals or vascular malformations in the mass. (G) There was no sign of recurrence in the CT image 12 months after surgical treatment.

Figure 2

(A) HE staining showed large immunoblast-like cells with monoclonal proliferation (HE, ×200). (B) HE staining showing large and round tumor cells with thick chromatins and very small nuclei (HE, ×400). (C–E) Immunohistochemistry staining showed that CD38 (C) and (D) CD138 were partly positive, while CD20 (E) was negative (×200).