Weekly Case

Title : Case 614

Age / Sex : 29 / M

What is your impression?

Chief complaint :

Headache, diplopia

Two weeks later, you can see the final diagonosis with a brief discussion of this case (Please submit only one answer).

Courtesy : 
You Seon Song, Pusan National University Hospital



Spinal dural lymphoma (Diffuse large B cell type)



On axial and sagittal CT scans, soft tissue density mass like lesion was seen in left posterior portion of central canal at C2-3 level. There was no internal calcification in the mass like lesion.

On axial and sagittal T2WI, mass like dural thickening causing spinal cord compression was seen. This lesion show iso- or slightly high SI on T1WI and homogeneous enhancement on contrast enhanced image. On DWI, the lesion show diffusion restriction.

On brain MRI, diffuse pachymeningeal thickening and enhancement was seen.


Differential Diagnosis:


Hypertrophic pachymeningitis related to infection

IgG4-related hypertrophic pachymeningitis




  • rare disease

  • Most of them are subtype of secondary CNS lymphoma, primary spinal dural lymphoma is very rare

  • Can be single or multiple and closely mimics meningiomas

  • Can cause spinal cord compression need decompression

  • Show hypercellularity with slightly increase T1 signal and homogeneous enhancement like lymphoma occurs at other site



  1. Primary Dural Spinal Lymphoma Presentation of a Rare Spinal Tumor Case – Case Rep Surg. 2015;639253

  2. Spinal Leptomeningeal Lymphoma Presenting as Pseudotumor Syndrome - : J Neuro-Ophthalmol 2013; 33: 13-16

Correct Answer
Total applicants 28 Correct answers 7
Name Institution
정보미 전문의
전인환 전문의
김동수 전공의
김기욱 국군대전병원, 전문의
이진영 전문의
김보람 전문의
김창현 전문의