case_images: PMC11021089_01
case_images: Axial (a) and coronal (b) computed tomography (CT) without contrast demonstrates a high-density subdural lesion. Axial (c) and coronal (d) magnetic resonance imaging with gadolinium contrast show residual contrast-enhancing extra-axial masses in the left frontal, temporal, and parietal lesions. Anteroposterior (e) and lateral (f) view of the left external carotid artery angiogram indicate arterial phase blush within the left convexity lesion. (g and h) Intraoperative findings showed a thickened dura mater (arrows) and a large tumor.
case_images: SNI-15-113-g001.jpg
case_images: PMC11021089_01_SNI-15-113-g001.jpg
case_images: F1
case_images: Computed tomography (CT) of the head revealed multiple high-density lesions in the left frontal and temporoparietal regions [Figures 1a and b]. Contrast-enhanced T1-weighted imaging revealed an extra-axial mass with homogeneous contrast enhancement [Figures 1c and d]. Digital subtraction angiography of the external carotid artery revealed a tumor stain consistent with the lesion location [Figures 1e and f]. Intraoperative findings revealed a thickened dura mater and a substantial tumor [Figures 1g and h].
case_images: Histopathological and Immunohistochemical features of EMZMBCL. (a) Small lymphocytic infiltration (hematoxylin and eosin). (b) CD20 and (c) Insulin-like growth factor 2 mRNA-binding protein-3 (IMP3) immunohistochemical stains show diffuse positive. Immunohistochemical examination revealed immunoglobulin light-chain restriction (Kappa (d): Lambda (e) = 100:2). EMZMBCL: Extranodal marginal zone mucosa-associated lymphoid tissue-type B-cell lymphoma.
case_images: SNI-15-113-g002.jpg
case_images: PMC11021089_01_SNI-15-113-g002.jpg
case_images: F2
case_images: Histopathological examination revealed small lymphocytic infiltration [Figure 2a]. The tumor exhibited positive immunoreactivity to the CD3, CD20, CD27, and insulin-like growth factor 2 messenger RNA-binding protein-3 (IMP3) [Figures 2b and c]. Immunohistochemical examination revealed immunoglobulin light chain restriction (Kappa: Lambda = 100:2) [Figures 2d and e].
case_images: Preradiotherapy magnetic resonance imaging (MRI). Axial (a) and coronal (b) MRI with gadolinium contrast show residual contrast-enhancing extra-axial masses in the left frontal, temporal, and parietal lesions. The thickening and enhancement of the dura extend along the falx and the left frontal and parietal lobes. MRI at three months after radiation therapy. Axial (c) and coronal (d) MRI with gadolinium contrast indicate the disappearance of residual contrast-enhancing extra-axial masses in the left frontal, temporal, and parietal lesions and normalization of the dural thickening and enhancement. MRI at eight months after radiation therapy. Axial (e) and coronal (f) MRI with gadolinium contrast reveal no recurrence.
case_images: SNI-15-113-g003.jpg
case_images: PMC11021089_01_SNI-15-113-g003.jpg
case_images: F3
case_images: MRI performed 3 months after radiation therapy [Figures 3c and d] showed tumour disappearance. MRI performed eight months after radiation therapy revealed no recurrence [Figures 3e and f].