Richter transformation of chronic lymphocytic leukemia presenting as a dural-based non-hodgkin lymphoma mass

Richter transformation is defined as a diffuse large cell lymphoma, occurring by transformation of chronic lymphocytic leukemia (CLL). We present a 64-year-old man with a history of CLL and a left parieto-occipital transtentorial extra-axial mass. The patient underwent CT and MR imaging, demonstrating a large dural-based mass with extracranial extension, which occluded the left transverse sinus. Biopsy of the mass proved a pathologic diagnosis of diffuse large cell non-Hodgkin lymphoma, consistent with Richter transformation of CLL.