Secondary Diffuse Large B-cell Lymphoma Mimicking Meningioma

Meningiomas are the most common benign intracranial tumors accounting for up to 30% of non-glial tumors of the central nervous system (CNS); on neuroimaging studies, they usually appear as a lobular, extra-axial mass with well-circumscribed margins mostly located in the parasagittal aspect of the cerebral convexity. On magnetic resonance imaging (MRI) of the brain, meningiomas are typically isointense to hypointense relative to grey matter in the T1-weighted sequence and isointense to slight hyperintense relative to grey matter on the T2-weighted sequence with avid homogeneous enhancement after contrast administration. A thin linear enhancement along the dura infiltrating away from the lesion, known as the dural tail sign, was once thought to be a pathognomonic feature of meningiomas, but this non-specific sign can also be seen in other meningioma-like lesions. Several benign and malignant pathologies may mimic some of the neuroimaging characteristics of meningiomas; among them dural metastases of lymphomas. When approaching a patient with suspected meningioma, close attention to the neuroimaging features may help distinguish them from meningioma-like lesions. Here we present the case of a woman with CNS involvement of non-Hodgkin lymphoma that presented with a dural mass resembling the neuroimaging characteristics of a meningioma.