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Case No. 30: Primary B-Cell Lymphoma

Case No. 30: Primary B-Cell Lymphoma

Primary B-cell lymphoma
Primary B-cell lymphoma

Modality:

CT Scan Brain (Axial view)

Report of Primary B-cell lymphoma:

CT scan showed well delineated, spontaneous high density, homogeneous lesion with a central calcification in the pineal region. Perilesional edema and mass effect were moderated. The lesion involved the posterior part of the third ventricle, and both thalami (“butterfly sign”).

Differential Diagnosis:

  • Germinoma.
  • Choriocarcinoma.
  • Endodermal sinus tumor and embryonal carcinoma
  • Lymphoma.
  • Pineocytoma.
  • Pineoblastoma.

Diagnosis:

Primary B-cell lymphoma.

Key Points:

In pineal region, lymphoma resembles germinoma and pineal parenchymal tumours. 60 years old or younger patients are affected. Hyperattenuation in CT and hypointensity in T2WI is suggestive of high cellular density. Calcifications are frequent in all pineal region tumours, particularly germinomas. Lymphoma is generally a homogenous lesion, while germinoma is more often heterogeneous with microcystic areas. Surrounding oedema is generally less marked in lymphoma than other intracranial tumours with low or no mass effect.

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