The majority of primary central nerve system (CNS) lymphomas (PCNSL) are diffuse large B-cell lymphomas. Anaplastic large cell lymphoma (ALCL) that is a type of T-cell tumor is very rare in the PCNSL. ALCLs are divided into two entities: anaplastic lymphoma kinase (ALK)-positive and ALK-negative. We report a case of a 26-year-old woman who presented with a one month historyof headache and nausea. Magnetic resonance imaging (MRI) of the brain revealed pituitary and pineal gland mass diagnosed as ALK-positive ALCL by endoscopic brain biopsy. She underwent chemotherapy following methotrexate (MTX) and cyclophosphamide + doxorubicin + vincristine + prednisolone (CHOP). The follow-up contrast-enhanced brain MRI showed no recurrent lesion after chemotherapy. In previous reports, most of the lesions were in cerebral hemisphere, dura mater and spinal cord. Many of these patients were given primary diagnoses of meningitis. To our knowledge, there is no case report of initial diagnosis of germinoma due to lesions in Neurohypophysis and pineal gland as in this case.
We report a case of secretory meningioma in a 64 − year − old woman who presented with depression and abnor − mal behavior . MRI demonstrated a well − enhanced tumor in the left middle fossa . The tumor was 3 cm in diameter and accompanied by remarkable brain edema in the left temporal Iobe . Caエotid angiograms showed multiple aneu − rysms of the bilateral internal carotid arteries . Through a left frontotemporal craniotomy , total removal of the tumor and neck clipping of the aneurysm of the left internal carotid artery were performed , After surgery , the patient 「 s symtoms improved and the edema disappeared . The tumor cells had many eosinophilic pseudopsammoma bodies . On immunohistochemistry , the tumor was positive fbr CEA and EMA and diagnosed as secretory meningioma . Tumor cells were also positive for VEGE which was possibly related to the severe brain edema in this case . Clinical and histopathological features of secretory meningioma are discussed ,
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