Diffuse Large B-Cell Lymphoma with Mass Lesions of Skull Vault and Ileocecum

  • Kosugi Shigeki
    Department of Internal Medicine, Division of Hematology and Oncology, St. Marianna University School of Medicine
  • Kume Masaaki
    The Second Department of Internal Medicine, Hiraka General Hospital
  • Sato Joji
    Department of Internal Medicine, Sato Hospital
  • Sakuma Ikuo
    Division of Radiology, Department of Medicine, Akita University School of Medicine
  • Moroi Junta
    Department of Neurosurgery, Research Institute for Brain and Blood Vessels-Akita
  • Izumi Keiichi
    Department of Surgery, Sato Hospital
  • Sato Yasukazu
    Department of Surgery, Sato Hospital
  • Nakamura Naoya
    Department of Pathology, Tokai University School of Medicine
  • Takahashi Masatomo
    Department of Internal Medicine, Division of Hematology and Oncology, St. Marianna University School of Medicine
  • Miura Ikuo
    Department of Internal Medicine, Division of Hematology and Oncology, St. Marianna University School of Medicine

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We report a rare case of non-Hodgkin lymphoma with mass lesions of skull vault and ileocecum. The patient was an 82-year-old Japanese woman who exhibited a painless subcutaneous scalp tumor in the right parietal region associated with no neurological abnormalities. Magnetic resonance imaging of the head demonstrated a mass in the skull vault with iso- to hypointense signals on both T1- and T2-weighted imaging. Biopsy of the mass revealed that the tumor comprised large cells that were immunoreactive for CD20 (L-26) and CD79a. Diffuse large B-cell lymphoma (DLBCL) was therefore diagnosed. Further investigation could not identify any other evidence of systemic lymphoma other than ileocecal lesions. She was treated by irradiation (45 Gy) of the mass on the parietal bone and with rituximab, pirarubicin, cyclophosphamide, and vincristine. The patient achieved complete remission after 3 cycles of systemic chemotherapy. As of 30 months after presentation, no signs of lymphoma have been found. [J Clin Exp Hematop 53(3) : 215-219, 2013]

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