Chen D, Yan X, Lu L, Xue K, Dong X. Lymphoma of the central nervous system originating from the septum pellucidum region: Two case reports with literature review.
Medicine (Baltimore) 2023;
102:e35954. [PMID:
37986283 PMCID:
PMC10659664 DOI:
10.1097/md.0000000000035954]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 10/10/2023] [Accepted: 10/13/2023] [Indexed: 11/22/2023] Open
Abstract
RATIONALE
Non-Hodgkin lymphoma affecting the brain, eyes, and cerebrospinal fluid without systemic spread is known as primary central nervous system lymphoma (PCNSL). While intracerebroventricular PCNSL is commonly found in the lateral ventricles and the third and fourth ventricles, the occurrence of PCNSL originating from the septum pellucidum is extremely rare.
PATIENT CONCERNS
Two patients presented with recent memory loss and high cranial pressure.
DIAGNOSES
Magnetic resonance imaging revealed a clear enhancing lesion in the septum pellucidum region. Pathological examination confirmed that both cases were primary large B-cell lymphoma GCB (germinal center B-cell-like) subtypes located in an "immune-privileged" area.
INTERVENTIONS
Both patients underwent total tumor resection, and the procedures were successfully completed without surgical complications.
OUTCOMES
Over a 1-year period, treatment included four cycles of high-dose methotrexate combined with temozolomide. During the follow-up period (19-23 months), no recurrence of the lymphoma was observed.
LESSONS
In cases of PCNSL in the septum pellucidum, it is crucial to consider it as a potential differential diagnosis for intraventricular tumors. Surgical interventions should focus on maximizing tumor resection while ensuring the protection of critical structures like the fornix and peripheral neural components. The role of surgery compared to biopsy, as well as the long-term complications, necessitates extended follow-up. Additionally, an individualized treatment approach, considering factors such as age, Karnofsky performance score, and organ function assessment, can lead to positive outcomes.
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