Primary leptomeningeal lymphoma

Primary leptomeningeal lymphoma is a rare disorder, and the neuroradiologic al characteristics or the complication of this rare disorder have not been well reported. We reported herein a patient with a primary leptomeningeal l ymphoma who has complication with subdural hematoma. The patient complained of headache and vomiting. Neurological examination revealed progressive cr anial nerve palsy. Cerebrospinal fluid examination disclosed monoclonal pro liferation of atypical B-lymphocytes. Cranial computed tomographic scans sh owed a left frontal mass with convex form to the brain parenchyma. T1-weigh ted magnetic resonance (MR) images disclosed subacute subdural hematoma. Ho wever, proton-weighted MR images showed high signal intensity in subarachno id space, which suggested leptomeningeal lymphoma. He underwent craniotomy, and the diagnosis of leptomeningeal lymphoma complicated with subdural hem atoma was confirmed. Systemic examinations disclosed no lymphomatous lesion s except for leptomeningus, and the diagnosis of primary leptomeningeal lym phoma was established. We suggested that subdural hematoma was associated w ith primary leptomeningeal lymphoma in this patient. Cerebrospinal fluid ex amination and proton-weighted MR imaging should be performed when progressi ve neurological abnormalities are found in patients with subdural hematoma.