A 78-year-old woman came to the hospital because of headache and tumefaction of the right temporal area. There were no other neurological symptoms. Cranial magnetic resonance imaging (MRI) showed a low-density area underneath the osseous inner plate, simulating a subdural hematoma (Figure 1). The histopathological analysis revealed neoplastic proliferation of large lymphoid cells with pleomorphic nuclei. Upon immunostaining, neoplastic cells were positive for CD79a, CD10, BCL6 and C-MYC and were negative for CD3 and CD5 (Figure 2). The proliferation index (Ki67) was 55%. The diagnosis of primary dural large B-cell lymphoma was established. Such a presentation of aggressive lymphoma is extremely unusual.1,2

Figure 1.

MRI showing a hypointense subdural lesion in the right temporoparietal region (arrow) on a T1-weighted sequence.

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Figure 2.

Neoplastic cells. (a). Hematoxylin & eosin stain (400×). (b). Immunostaining for BCL-2 (400×). (c). Immunostaining for BCL-6 (400×). (d). Immunostaining for C-MYC (400×).

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The authors declare no conflicts of interest.