PMC4533500_01
Preoperative T1-weighted magnetic resonance (MR) imaging showing an isointense (A) and large heterogenously enhanced large tumor in response to gadolinium on axial (B) and coronal imaging (C) along the left trigeminal nerve. T2-weighted MR image (D) shows an isointense mass.
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F1
T2-weighted imaging with homogenous enhancement with gadolinium (Fig. 1A-D).
Operative schema (A) and photograph (B). The trigeminal nerve (arrowhead) was encased by the pinkish tumor (triple small arrow). The tumor was easily detached from the nerve fiber. Facial-auditory nerve complex (long arrow) coursed into the internal auditory meatus.
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F2
To confirm the diagnosis, retrosigmoid lateral suboccipital craniotomy was performed. The tumor was pinkish and encased the trigeminal nerve, and extended into the Meckel's cave. The tumor was easily detached from the trigeminal nerve fiber and was partially removed (Fig. 2A, B).
Histological findings revealed bizarre and large tumor cells were arranged in solid areas. A: Nuclei with atypia and mitoses are present. B: Many of tumor cells were positive for CD79alphaantibody.
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Histological findings revealed the bizarre and large tumor cells were arranged in solid areas and predominant of nuclei with atypia and mitoses (Fig. 3A). Many of tumor cells were positive for CD79alpha (Fig. 3B), which was compatible with a diagnosis of diffuse large B cell lymphoma (DLBCL) that had metastasized to the Meckel's cave and the trigeminal nerve.
Four years after operation, no recurrent tumors were present observed on T1-weighted (A, B) or T2-weighted (C) magnetic resonance (MR) imaging with gadolinium enhancement.
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F4
No recurrent tumor was found on MRI (Fig. 4A-D).