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Table of Contents    
Year : 2013  |  Volume : 61  |  Issue : 3  |  Page : 334-336

A case of primary skull lymphoma: Review of literature

1 Department of Neurosurgery, Shriram Chandra Bhanja Medical College and Hospital, Cuttack, Odisha, India
2 Department of Pathology, Shriram Chandra Bhanja Medical College and Hospital, Cuttack, Odisha, India

Date of Submission11-Nov-2012
Date of Decision13-Nov-2012
Date of Acceptance30-May-2013
Date of Web Publication16-Jul-2013

Correspondence Address:
Satya Bhusan Senapati
Department of Neurosurgery, Shriram Chandra Bhanja Medical College and Hospital, Cuttack, Odisha
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0028-3886.115101

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How to cite this article:
Mishra SS, Senapati SB, Dhir MK, Das S, Burma S. A case of primary skull lymphoma: Review of literature. Neurol India 2013;61:334-6

How to cite this URL:
Mishra SS, Senapati SB, Dhir MK, Das S, Burma S. A case of primary skull lymphoma: Review of literature. Neurol India [serial online] 2013 [cited 2021 Mar 3];61:334-6. Available from:


Extranodal lymphoma can be either primary or secondary and can involve any organ. Bone involvement is commonly secondary and non-Hodgkin lymphoma (NHL) type. Primary NHL of the skull is extremely rare. This report presents a case of primary NHL of the skull in a non-immunocompromised individual and reviews the literature. [1],[2],[3],[4],[5],[6],[7],[8],[9],[10],[11],[12],[13],[14],[15],[16],[17],[18],[19],[20],[21],[22]

A 34-year-old male presented with painless progressive swelling over left frontal area for over 1-year duration. Local examination, X-ray skull, plain and contrast cranial computed tomography (CT) scan were inconclusive [Figure 1]a-c. Skiagram of chest, ultrasound abdomen, and bone marrow biopsy revealed no abnormality. Left frontal circumferential craniectomy surrounding the lesion, with 1 cm healthy skull margin was done. Extracranial portion was removed along with involved bone, epidural component curetted out and dura cauterized. Histological and immunopathologic examination confirmed the diagnosis of diffuse large B-cell lymphoma [Figure 2]a-c. Post-operatively patient was treated with chemotherapy (CHOP regimen, containing cyclophosphamide, adriamycin, vincristine and prednisolone ), followed by local radiation therapy. After 6 months of surgery, patient is doing well, without signs of systemic dissemination.
Figure 1

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Figure 2

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Review of English literature revealed 24 such cases [Table 1].
Table 1: Comprehensive review of published 24 reports in different journal, along with present case is given in tabular form blow

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Clinical presentations can be as a solitary or diffuse skull lesion with or without focal deficits. Hyperdense contrast enhancing mass was the CT finding in all the 20 patients who had CT scan. Hyperintense with contrast enhancement in T1-weighted was the magnetic resonance imaging finding in three cases and isointense in other three patients. Of the 23 patients, skull bone erosion (BE) was found in 14 patients, hyperostiosis in three patients and soft tissue component without skull BE in three patients. The optimum treatment includes surgery plus systemic chemotherapy and local radiotherapy. In patients with immunocompromized state, diffuse lesions and patients who do not tolerate systemic chemotherapy; biopsy followed by involved field radiation therapy is a reasonable alternate option.

We conclude that primary skull lymphoma is very rare and the possibility must be kept in mind in the differential diagnosis of primary skull lesions, irrespective of the immune status.

 » References Top

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2.Holtås S, Monajati A, Utz R. Computed tomography of malignant lymphoma involving the skull. J Comput Assist Tomogr 1985;9:725-7.  Back to cited text no. 2
3.Maiuri F, Corriero G, Giamundo A. Primary lymphoma of the cranial vault. J Neurosurg Sci 1987;31:183-6.  Back to cited text no. 3
4.Parekh HC, Sharma RR, Keogh AJ, Prabhu SS. Primary malignant non-Hodgkin's lymphoma of cranial vault: A case report. Surg Neurol 1993;39:286-9.  Back to cited text no. 4
5.Isla A, Alvarez F, Gutiérrez M, Gamallo C, García-Blázquez M, Vega A. Primary cranial vault lymphoma mimicking meningioma. Neuroradiology 1996;38:211-3.  Back to cited text no. 5
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7.Jamjoom AB, Jamjoom ZA, Naim-Ur-Rahman, Cheema MA. Primary midline cranial vault lymphoma simulating a parasagittal meningioma: The role of angiography in preoperative diagnosis. Neurosurg Rev 1998;21:202-5.  Back to cited text no. 7
8.Jiménez Moragas JM, Sánchez Rodríguez A, Sierra Camerino R, Palomo González MJ. Non-Hodgkin's disease of the skull in a patient with AIDS. An Med Interna 1999;16:186-8.  Back to cited text no. 8
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13.Horstman AL, Go RS, Bottner WA. Cranial vault lymphoma. Haematologica 2004;89:EIM06.  Back to cited text no. 13
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21.Martin J, Ramesh A, Kamaludeen M, Udhaya, Ganesh K, Martin JJ. Primary non-Hodgkin's lymphoma of the scalp and cranial vault. Case Rep Neurol Med 2012;2012:616813.  Back to cited text no. 21
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  [Table 1]

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