PMC7451177_01
Image examinations of the case. Head computed tomography examinations before operation showed the mass lesion around the left sphenoid bone extending to lateral to the left temporal middle fossa and medial to sphenoid sinus (a). The mass lesion was heterogeneously enhanced with the gadolinium-enhanced magnetic resonance image (Gd-MRI) (b). Fluorodeoxyglucose-positron emission tomography (FDG-PET) showed multiple lesions in the left sphenoid bone, nasal cavity, bilateral humeri, and left femur (c). Two weeks after the first presentation to our hospital, the tumor size was increased about the twice size compared as the previous study (d). After the removal of tumor and chemotherapy, his Gd- MRI and FDG-PET showed the disappearance of the lesion (e and f).
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F1
Head computed tomography (CT) and gadolinium-enhanced brain magnetic resonance image (Gd-MRI) showed the mass lesion around the left sphenoid bone extending both to the left temporal middle fossa and to sphenoid sinus [Figure 1a and b]. Fluorodeoxyglucose-positron emission tomography (FDG-PET) showed multiple lesions in the left sphenoid bone, nasal cavity, bilateral humeri, and left femur [Figure 1c]. Two weeks later, the tumor volume was increased compared as those of the previous study [Figure 1d], so we performed partial removal of tumor by endoscopic trans- nasal transsphenoidal surgery under general anesthesia. After the eighth course of R-THP-COP, his Gd-MRI and FDG-PET showed the disappearance of the lesion [Figure 1e and f], and his symptoms completely disappeared.
Histopathological examinations including immunohistochemistry and flow cytometry showed that large cells with nuclei display prominent nucleoli that diffusely infiltrate the brain tissue in hematoxylin-eosin staining (a), cluster of differentiation (CD) 3(-) (b), CD5(+) (c), CD10(-) (d), multiple myeloma oncogene (MUM)-1(+) (e), Bcl-2(+) (f), Bcl-6(+) (g), and EBER (EBV-encoded small RNA) in situ hybridization (EBER-ISH) (-) (h), thus the diagnosis was confirmed as diffuse large B-cell lymphoma.
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Histopathological examinations showed that large B cells with nuclei display prominent nucleoli that diffusely infiltrate the brain tissue in hematoxylin-eosin staining [Figure 2a], cluster of differentiation (CD) 3(-) [Figure 2b], CD5(+) [Figure 2c], CD10(-) [Figure 2d], multiple myeloma oncogene (MUM)-1(+) [Figure 2e], Bcl-2(+) [Figure 2f], Bcl-6(+) [Figure 2g], and EBER (EBV-encoded small RNA) in situ hybridization (EBER-ISH) (-) [Figure 2h], thus the diagnosis was confirmed as diffuse large B-cell lymphoma (DLBCL).