Primary Central Nervous System Lymphoma Presenting as a Space-occupying Lesion: A Case Report
Mohamed Nabil Mohamed Nazri *
Neurosurgery Unit, Department of Surgery, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, MYS, Malaysia.
Azizi Abu Bakar
Neurosurgery Unit, Department of Surgery, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, MYS, Malaysia.
*Author to whom correspondence should be addressed.
Abstract
Primary central nervous system lymphoma (PCNSL) is an aggressive and rare subtype of diffuse large B-cell lymphoma, which is specifically confined to the central nervous system (CNS). As a mature B-cell neoplasm, PCNSL's unique features often result in nonspecific clinical presentations, making diagnosis challenging. Here, we present a case of a 62-year-old woman who presented with a 1-week history of right-sided body weakness, altered behaviour, incoherent speech, and facial asymmetry. A Computed Tomography (CT) scan of the brain revealed a space-occupying lesion in the frontoparietal region with associated mass effect and midline shift. The patient underwent an emergency craniotomy with tumour resection, after which she made a good recovery and was discharged home a few days later. Histopathological examination confirmed the diagnosis of primary CNS diffuse large B-cell lymphoma. This case highlights the diagnostic and management challenges associated with PCNSL, which will be discussed in detail.
Keywords: Primary central nervous system lymphoma, diffuse large B-cell lymphoma, central nervous system, brain tumour, chemotherapy