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Background <p>Primary central nervous system lymphoma (PCNSL) accounts for only 2–5% of all primary central nervous system (CNS) tumors. However, its radiologic features are variable and diagnosis can be difficult. Inappropriate treatments before biopsy can lead to inconclusive pathologic findings because the tumor is highly corticosteroid sensitive. Knowing the features related to PCNSL helps put this aggressive tumor on the list of initial diagnoses.</p> Case presentation <p>An immunocompetent 55-year-old male patient was admitted with epileptic seizures. Brain imaging findings such as intratumoral hemorrhages and increased perfusion led to an initial diagnosis of cranial metastases. Corticosteroid administration as an anti-edema treatment caused prominent regression of the tumor. Biopsy performed after tumor regrowth revealed highly aggressive diffuse large B cell lymphoma.</p> Conclusions <p>It is important to be aware of the usual, but also the rare features of PCNSL because it has distinct treatment and prognostic implications compared with other brain tumors and disorders.</p>

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Uncommon radiological findings of aggressive primary central nervous system lymphoma in an immunocompetent patient

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年2月9日

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  • Sevda Diker,
  • Nasıf Ortaş,
  • Çağın Ozankaya,
  • Kemal Kararlı

摘要

Background

Primary central nervous system lymphoma (PCNSL) accounts for only 2–5% of all primary central nervous system (CNS) tumors. However, its radiologic features are variable and diagnosis can be difficult. Inappropriate treatments before biopsy can lead to inconclusive pathologic findings because the tumor is highly corticosteroid sensitive. Knowing the features related to PCNSL helps put this aggressive tumor on the list of initial diagnoses.

Case presentation

An immunocompetent 55-year-old male patient was admitted with epileptic seizures. Brain imaging findings such as intratumoral hemorrhages and increased perfusion led to an initial diagnosis of cranial metastases. Corticosteroid administration as an anti-edema treatment caused prominent regression of the tumor. Biopsy performed after tumor regrowth revealed highly aggressive diffuse large B cell lymphoma.

Conclusions

It is important to be aware of the usual, but also the rare features of PCNSL because it has distinct treatment and prognostic implications compared with other brain tumors and disorders.