Primary central nervous system lymphoma of the third ventricle with intra‑tumoral hemorrhage: A case report and literature review
- Yu Muroya
- Kohei Suzuki
- Shohei Nagasaka
- Yoshiteru Nakano
- Junkoh Yamamoto
Affiliations: Department of Neurosurgery, University of Occupational and Environmental Health, Kitakyushu, Fukuoka 807‑8555, Japan
- Published online on: December 15, 2022 https://doi.org/10.3892/ol.2022.13633
Copyright: © Muroya
et al. This is an open access article distributed under the
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Primary central nervous system lymphoma (PCNSL) is a rare brain tumor that most commonly arises in the cerebral white matter, basal ganglia, peri‑ventricle or corpus callosum. Confinement of PCNSL to the third ventricle is extremely rare, and seldom presents with intratumoral hemorrhage (ITH). The present study described the case of a 75‑year‑old woman who presented with obstructive hydrocephalus due to third‑ventricle PCNSL. On magnetic resonance imaging (MRI), the tumor presented ITH on T2*‑weighted images and a highly elevated regional cerebral blood volume on dynamic susceptibility contrast‑enhanced MRI (DSC‑MRI). Due to the high elevation of the regional cerebral blood volume, high‑grade glioma was suspected as a preoperative diagnosis. The patient underwent endoscopic tumor biopsy and third ventricle PCNSL was successfully diagnosed. The patient achieved good prognosis at an early stage after the start of treatment initiation. There are many differential considerations for a third‑ventricle tumor, and DSC‑MRI can help the differential diagnosis of these tumors. Furthermore, the presence of ITH can lead to the inaccurate estimation of regional cerebral blood volume values. Overall, silent or microhemorrhage in PCNSL may be underestimated, and clinicians should therefore carefully evaluate tumor vascularity by MRI.