Primary Fourth Ventricular B-cell Lymphoma: Case Report and Literature Review

Brahim Eljebbouri, Miloudi Gazzaz, Adil Belhachmi, Mohammed Mrabti, Jawad Laaguili, Brahim ElMostarchid


-BACKGROUND: Primary central nervous lymphoma (PCNSL) is a rare variant of extranodal non-Hodgkin's lymphoma with a especially poor
prognosis. The diagnosis is usually encountered in immunodeficient
patients but is also encountered, albeit uncommonly, in the
immunocompetent. The finding of PCNSL in the fourth ventricle is very
-CASE DESCRIPTION: A 23-year-old woman had a 7 months history of
intermittent vertigo, nausea, vomiting, and progressively unsteady gait.
MRI of the brain revealed a 4.5 cm enhancing tumor in the fourth
ventricle. Metastasis or high-grade glioma was suspected. The
neuropathological findings -after surgery- were compatible with a diffuse
large B-cell lymphoma. A slit lamp examination, bone marrow biopsy, and
imaging studies for extracranial lesions were unremarkable.
-CONCLUSIONS: We suggest that PCNSL be listed in the differential
diagnosis of fourth ventricle tumors with well-circumscribed margins and
homogenous contrast enhancement.


Central nervous system; Diffuse large-cell lymphoma; Fourth ventricle tumor; Immunocompetence

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